Structured exercise program aims to prevent cardiotoxicity in breast cancer patients undergoing anthracycline/trastuzumab therapy
Background
Breast cancer remains a leading cause of cancer-related deaths among women. While treatments like anthracyclines and anti-HER2 antibodies (e.g., trastuzumab) are highly effective, they carry a significant risk of chemotherapy-induced cardiotoxicity (CTRCD). Cardio-oncology rehabilitation programs aim to mitigate these outcomes, but their specific preventive efficacy against CTRCD in this vulnerable population remains uncertain. This trial addresses that uncertainty by evaluating a structured exercise intervention.
Study Design
The CARPTOX-BC trial is a randomized, open-label clinical study enrolling 284 women aged 18-70 years with stage I-III breast cancer scheduled for neoadjuvant or adjuvant therapy with anthracyclines and/or trastuzumab. Participants are randomized 1:1 to either a structured exercise program (three supervised out of five weekly aerobic and resistance exercise sessions) or an active control group receiving only exercise recommendations. The primary endpoint is the prevention of CTRCD, defined by 2022 ESC criteria, including changes in global longitudinal strain and elevations in cardiac troponin I/T or natriuretic peptides.
Results
This abstract describes the rationale and design of the CARPTOX-BC trial. The study is currently in progress, and definitive results are pending disclosure upon completion. However, the researchers anticipate that the structured exercise program will significantly reduce the incidence of chemotherapy-induced cardiotoxicity (CTRCD) associated with anthracycline and/or HER2 antibody treatments. They also expect to observe improvements in secondary outcomes, including various systolic and diastolic echocardiographic parameters, cardiometabolic biomarkers, and overall quality of life among the intervention group. The study aims to provide robust evidence for a non-pharmacological strategy to mitigate cardiac damage in this vulnerable patient population. The role of traditional cardiovascular risk factors in CTRCD onset will also be explored.
The trial expects a structured exercise program to reduce CTRCD incidence and enhance cardiometabolic markers and quality of life.
Key Findings
- Expected reduction in incidence of chemotherapy-induced cardiotoxicity (CTRCD).
- Anticipated improvements in systolic and diastolic echocardiographic parameters.
- Expected enhancements in cardiometabolic biomarkers.
- Anticipated improvements in patient quality of life.
- Exploration of traditional cardiovascular risk factors in CTRCD onset.
Why It Matters
If successful, this trial could establish a structured exercise program as a vital non-pharmacological intervention for preventing chemotherapy-induced cardiotoxicity in breast cancer patients. This would offer a practical, accessible strategy to mitigate a major side effect of life-saving treatments like anthracyclines and trastuzumab, potentially improving long-term cardiovascular health and quality of life. The detailed protocol for supervised aerobic and resistance exercise, if proven effective, could be readily integrated into cardio-oncology rehabilitation guidelines, providing a clear, actionable recommendation for clinicians and patients. This could shift the paradigm from reactive management to proactive prevention of cardiac damage during cancer therapy.
breast cancer
cardiotoxicity
exercise
anthracycline
trastuzumab
clinical trial