Prevention of CHOP-induced Chronic Cardiotoxicity

Overview

The purpose of this study is to assess the protective effect of Valsartan on chronic cardiotoxicity induced by CHOP.

Full Title of Study: “The Multi-centers Trial for Patients With Non-Hodgkin’s Lymphoma to Assess the Protective Effect of Valsartan on Chronic Cardiotoxicity Induced by CHOP”

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Prevention
    • Masking: None (Open Label)
  • Study Primary Completion Date: September 2010

Detailed Description

Doxorubicin has been one of the most important key drugs in treatment for malignancies. However, its use is limited by dose-dependent cumulative cardiotoxicity. This multi-centers trial was designed to investigate the preventive effect of Valsartan, the angiotensin II type 1 receptor blocker (ARB) on chronic cardiotoxicity due to doxorubicin based chemotherapy. Patients with untreated non-Hodgkin's lymphoma who are scheduled to receive at least 6 courses of the standard CHOP (-R) will be randomized by the minimization methods to the treatment group with Valsartan (80mg once daily by oral during entire 6 courses of CHOP) or control group. Cardiac function will be evaluated in detail before and after 3 and 6 courses of CHOP (-R).

Interventions

  • Drug: Valsartan
    • Patients allocated into ARB administration group take Valsartan (80mg/day) from the day of the start of 1st CHOP until the completion of all the evaluations.

Arms, Groups and Cohorts

  • Experimental: ARB administration
    • 80mg/day from the day of the start of 1st CHOP until the completion of all the evaluations
  • No Intervention: non-administration
    • ARB non-administration group

Clinical Trial Outcome Measures

Primary Measures

  • Cardiac Event after 3rd and 6th course of CHOP(-R)
    • Time Frame: Basically 14-21 (at a maximum 28) days after the start of 3rd and 6th course of CHOP(-R).

Secondary Measures

  • Changes of ECG, UCG and serum markers after 3 and 6 courses of CHOP (-R)
    • Time Frame: 14-21 (at a maximum 28) days after the start of 3rd and 6th course of CHOP(-R).

Participating in This Clinical Trial

Inclusion Criteria

  • Clinical diagnosis of non-Hodgkin's lymphoma (NHL) – Untreated lymphoma – Performance status from 0 to 1, – Total serum bilirubin < 2.0 mg/dl – Serum creatinine level < 2.0 mg/dl – Ejection fraction of the left ventricle >50 % – Systolic blood pressure at rest being 90 mmHg or more Exclusion Criteria:

  • Severe complication including chronic or acute heart failure, angina, old myocardial infarction, liver cirrhosis, and interstitial pneumonia – Pregnancy, nursing mothers or women of child-bearing potential – Hypertension under medication – Diabetes mellitus under medication – Hyperthyroidism, nephrotic syndrome, Cushing's syndrome – Atrial arrythmias – Severe psychopathy – Cerebrovascular accidents within the past 3 months – Positive serum HBs antigen or HCV antibody – A history of renal failure – A contraindication to A-II antagonists or noncompliance – Treatment with any of the following drugs within the past 3 months : A-II antagonists, ACE inhibitors, vitamin E, probucol, calcium antagonists, beta-blockers, and steroid pulse therapy.

Gender Eligibility: All

Minimum Age: 15 Years

Maximum Age: 70 Years

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Osaka City University
  • Provider of Information About this Clinical Study
    • Hirohisa Nakamae, MD. PhD., Osaka City University
  • Overall Official(s)
    • Masayuki Hino, MD, PhD, Study Chair, Graduate School of Medicine, Osaka City University
    • Hirohisa Nakamae, MD, PhD, Principal Investigator, Graduate School of Medicine, Osaka City University

References

Toko H, Oka T, Zou Y, Sakamoto M, Mizukami M, Sano M, Yamamoto R, Sugaya T, Komuro I. Angiotensin II type 1a receptor mediates doxorubicin-induced cardiomyopathy. Hypertens Res. 2002 Jul;25(4):597-603. doi: 10.1291/hypres.25.597.

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