Evidence mapPaperPMID 40172740Full record

Trial reportBreast cancer research and treatment2025

Risk-guided cardioprotection with carvedilol in patients with breast cancer (CCT guide): a phase 1 randomized clinical trial.

Wonyoung Jung, Rebecca A Hubbard, Amanda M Smith, Kyunga Ko, Anran Huang, Jessica Wang, Jordan M Isaacs, Liyong Zhang, Peter P Liu, Zhen Chen and 13 more

Registry-linked trialAbstract readClinical Trial, Phase IRandomized Controlled Trial
In one paragraph

Trial report in Breast cancer research and treatment, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04023110 (A Pilot Study of Risk-Guided Cardioprotection With Carvedilol in Breast Cancer Patients Treated With Doxorubicin and/or Trastuzumab), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04023110 phase1completednot on this map

A Pilot Study of Risk-Guided Cardioprotection With Carvedilol in Breast Cancer Patients Treated With Doxorubicin and/or Trastuzumab

TypeinterventionalSponsorAbramson Cancer Center at Penn MedicineRan2019 to 2025Enrolled68ConditionsCardiotoxicity, Risk Factor, Cardiovascular, Toxicity Due to Chemotherapy, Breast CancerArmsCarvedilol
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

23 authors.

Wonyoung JungDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Rebecca A HubbardDepartment of Biostatistics, Brown University School of Public Health, Providence, RI, USA.
Amanda M SmithDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Kyunga KoDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Anran HuangDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jessica WangDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jordan M IsaacsDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Liyong ZhangUniversity of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
Peter P LiuUniversity of Ottawa Heart Institute, University of Ottawa, Ottawa, ON, Canada.
Zhen ChenDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Payal D ShahDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
David MintzerDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Saveri BhattacharyaDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Hayley M KnollmanDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Amy S ClarkDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Daniel Koropeckyj-CoxDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Melissa MessingerDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Nicholas S WilcoxDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Congying XiaDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Vivek NarayanDivision of Hematology and Oncology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
Jenica N UpshawDivision of Cardiology, Tufts Medical Center, Boston, MA, USA.
Saro H ArmenianDepartment of Pediatrics and Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, CA, USA.
Bonnie KyDivision of Cardiology, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. bonnie.ky@pennmedicine.upenn.edu.

Funding

Multimarker Risk Prediction in Cancer Therapy CardiotoxicityR01HL118018 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI KY, BONNIE · 2014 to 2018
$3.7M
MENTORING IN PATIENT-ORIENTED RESEARCH IN DEEP PHENOTYPING IN CARDIO-ONCOLOGYK24HL167127 · NHLBI · UNIVERSITY OF PENNSYLVANIA · PI Bonnie Ky · 2023 to 2026
$496k
American Heart Association 849569NHLBI NIH HHS K24 HL167127NHLBI NIH HHS R01 HL118018NIH HHS R01 HL118018
6 · The paper itself

Abstract

purposeBreast cancer treatment results in increased cardiotoxicity risk; a risk-guided approach to cardioprotection has not been fully tested.

methodsThis single-center, randomized Phase I trial enrolled patients with Stage I-III breast cancer who planned to receive anthracycline and/or trastuzumab therapy. An internally validated cardiotoxicity risk score classified participants as low or elevated risk. Elevated risk participants were randomized to receive open-label carvedilol or usual care for 12 months, beginning at cancer therapy initiation. Study visits occurred at baseline, 3, 6, 9, 12, and 24 months. Primary outcomes included feasibility, safety, and tolerability. Exploratory outcomes included echocardiography, biologic, and patient-reported measures.

resultsOf the 166 eligible patients approached, 68 (41%) agreed to participate and ultimately enrolled. Among these participants (median age 52, 35% Black), 49 were classified as low and 19 elevated risk. Within the elevated risk group, 13 were randomized to carvedilol and 6 usual care. For those randomized to carvedilol, the median maximum dose was 6.25 mg twice daily, with 93% adherence. Adverse events of interest (grade 3 + bradycardia, hypotension, or fatigue) occurred in 9% with carvedilol, 13% in usual care, and 4% in low risk groups. One (1.5%) low risk participant experienced cardiac dysfunction. There were no substantial differences in secondary outcomes across groups. The participant withdrawal rate was 7%.

conclusionsThis Phase 1 trial demonstrates that a risk-guided strategy can be applied to patients with active cancer. However, additional strategies are necessary to optimize the design and execution of non-treatment intervention trials in patients with active cancer.

trial registrationNCT04023110.

Indexed as

Antineoplastic Combined Chemotherapy ProtocolsBreast NeoplasmsCardiotonic AgentsCardiotoxicityCarvedilolAdultAgedAnthracyclinesFemaleHumansMiddle AgedTrastuzumabTreatment OutcomeAnthracyclinesCardiotonic AgentsCarvedilolTrastuzumabAnthracyclinesBreast cancerCardiotoxicityCarvedilolPhase 1Risk-guided

Identifiers

PMID40172740
PMCPMC12006281

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.