This is a companion study to the "Pragmatic Randomized Trial of Proton vs Photon Therapy for Patients with non-Metastatic Breast Cancer Receiving Comprehensive Nodal Radiation: A Radiotherapy Comparative Effectiveness (RadComp) Consortium Trial" (NCT02603341). The investigators will collect cardiovascular (CV) biomarkers and echocardiograms prior to, during, and for up to 1 year following radiation for a subset of patients enrolled on RadComp and to evaluate the impact of proton vs photon radiation therapy (RT) on CV function and structure.
The study population of the companion study will consist of newly enrolled RadComp trial participants. Patients on this ancillary will be consented prior to RadComp randomization to decrease the bias secondary to RT type and enhance internal validity. The study will define the early changes in biomarkers, imaging measures, and RT dose volume metrics and long-term (5-10 year) CV clinical outcomes using the RadComp parent study's infrastructure for clinical data collection and long-term follow-up. Blood samples, echocardiograms, and questionnaires are obtained at baseline (between end of chemotherapy and start of RT), immediately after the end of RT, and at 6 months and 12 months after the end of RT. An additional blood sample will be collected at 4 weeks after the start of RT. Clinical, demographic, and patient reported outcomes data are collected as part of the RadComp parent study. In addition to data collected by RadComp, we will collect a limited set of clinical data and two additional quality of life instruments for the companion study.
Study Type
OBSERVATIONAL
Enrollment
172
Assignment to proton vs photon by randomization on RadComp parent study.
University of Alabama
Birmingham, Alabama, United States
Northwestern Medicine
Warrenville, Illinois, United States
Johns Hopkins
Baltimore, Maryland, United States
Memorial Sloan Kettering Cancer Center
New York, New York, United States
Abramson Cancer Center at University of Pennsylvania
Philadelphia, Pennsylvania, United States
University of Washington
Seattle, Washington, United States
Left ventricular ejection fraction (LVEF)
Change in echocardiography derived LVEF from baseline
Time frame: 14 months
Right Ventricular (RV) Fractional Area Change (FAC)
Change in echocardiography derived RV FAC from baseline
Time frame: 14 months
Circulating N-terminal pro B-type natriuretic peptide (NTproBNP)
Change in NTproBNP levels from baseline
Time frame: 14 months
Circulating Placental Growth Factor (PIGF)
Change in PIGF levels from baseline
Time frame: 14 months
Circulating Growth Differentiation Factor-15 (GDF-15)
Change in GDF-15 levels from baseline
Time frame: 14 months
LV systolic strain
Change in 2D echocardiography derived LV global longitudinal strain and circumferential strain from baseline
Time frame: 14 months
Echocardiography derived Ventricular Arterial Coupling Measurement
Change from baseline in ventricular arterial coupling as defined by end systolic elastance divided by effective arterial elastance
Time frame: 14 months
Diastolic function (E/e')
Change in E/e' from baseline as measured by echocardiogram
Time frame: 14 months
Circulating Troponin T(TnT)
Change in high-sensitivity TnT levels from baseline
Time frame: 14 months
Circulating high-sensitivity C-Reactive Protein (hsCRP)
Change in hsCRP levels from baseline
Time frame: 14 months
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