Grant: Operating Grant - Priority Announcement: Breast Cancer

A growing number of women are diagnosed with breast cancer each year and it is one of the most common causes of death. A new chemotherapy drug called trastuzumab has been shown to decrease the risk of cancer recurrence and improve patient survival. Unfortunately, this breast cancer treatment may also result in significant damage to the heart muscle that can ultimately lead to heart failure. We have recently shown that women receiving trastuzumab develop heart enlargement, an early sign of heart failure. Effective medications for heart failure are available but have not been well studied in the prevention of this chemotherapy related heart damage. The main objective of this project is (1) to determine if two commonly prescribed heart failure medications called ACE-inhibitors and beta blockers can prevent MRI evidence of early heart damage in breast cancer patients receiving trastuzumab. Other objectives of this project are: (2) to determine if a blood test can also detect early signs of heart damage, (3) to better understand the cause of the heart damage by studying relatively new blood tests and an in-depth MRI of the heart, (4) use MRI to determine if the damage to these patients' hearts continues in the year following chemotherapy. We will perform a study called a randomized controlled trial. Patients will receive either a heart failure pill or a placebo for the 1 year duration of their chemotherapy. They will each undergo blood tests and a heart MRI before chemotherapy, at 3 months, at 12 months and at 24 months. On the MRI, we will measure if the heart failure pill prevents the heart from enlarging. On the 24 month scan, we will be interested to see if the heart enlargement remains over time, worsens or gets better. We will also determine if any of the blood tests seem to predict heart enlargement.