Studying Biomarkers in Detecting Heart Damage in Patients Receiving Chemotherapy

• Sensitivity and specificity of serial LVEF measurements in detecting cardiotoxicity [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• Clinical management and outcomes of patients with abnormal cardiac biomarkers or clinically defined cardiotoxicity during chemotherapy [ Time Frame: 12 months ] [ Designated as safety issue: No ]
• Supportive utility of patient-reported symptoms for the development of cardiac-related toxicity [ Time Frame: 12 months ] [ Designated as safety issue: No ]

• Sensitivity and specificity of serial LVEF measurements in detecting cardiotoxicity [ Designated as safety issue: No ]
• Clinical management and outcomes of patients with abnormal cardiac biomarkers or clinically defined cardiotoxicity during chemotherapy [ Designated as safety issue: No ]
• Supportive utility of patient-reported symptoms for the development of cardiac-related toxicity [ Designated as safety issue: No ]

RATIONALE: Studying samples of blood in the laboratory from patients receiving chemotherapy may help doctors identify and learn more about biomarkers related to heart damage due to chemotherapy. It may also help doctors plan the best treatment.

PURPOSE: This clinical trial is studying how well biomarkers work in detecting heart damage in patients receiving chemotherapy.

OBJECTIVES:

Primary

• To assess the sensitivity and specificity of cardiac biomarkers, specifically B-type natriuretic peptide (BNP) and troponin I, in detecting cardiotoxicity in patients undergoing anthracycline-based chemotherapy.

Secondary

• To define the sensitivity and specificity of serial LVEF measurements in detecting cardiotoxicity.
• To describe the clinical management and outcomes of patients identified with abnormal cardiac biomarkers or clinically defined cardiotoxicity during chemotherapy.
• To confirm the supportive utility of patient-reported symptoms for the development of cardiac-related toxicity.

OUTLINE: This is a multicenter study.

Patients receive anthracycline-based chemotherapy for approximately 8 courses.

Patients undergo physical exam, ECHO, EKG, and laboratory assessments, including measurement of B-type natriuretic peptide (BNP) and troponin I biomarkers, at baseline and periodically for up to 12 months. Patients also complete the M.D. Anderson Symptom Index-Heart Failure questionnaire at baseline and periodically for up to 12 months. Patients with an identified cardiac event, suspected cardiotoxicity, or abnormal biomarkers are referred to a cardiologist for treatment.

After completion of chemotherapy, patients are followed up at 6 and 12 months.

• Cardiac Toxicity
• Unspecified Adult Solid Tumor, Protocol Specific

• Drug: Systemic chemotherapy
• Other: Laboratory biomarker analysis
  Other Name: Biomarker Testing
• Other: Questionnaire administration
  Other Names:

  • Survey
  • Questionnaire

DISEASE CHARACTERISTICS:

• Planning to start a new course of chemotherapy that includes an anthracycline

  • Does not have to be first-line therapy
• B-type natriuretic peptide (BNP) < 200 pg/mL
• Troponin I < 0.4 ng/mL

PATIENT CHARACTERISTICS:

• Life expectancy > 12 months
• Left ventricular ejection fraction (LVEF) ≥ 50%
• No unstable angina within the past 3 months
• No myocardial infarction within the past 3 months
• No decompensated heart failure within the past 3 months
• No pre-existing or prior symptomatic arrhythmia within the past 3 months
• No severe pulmonary disease (FEV ≤ 1.0 L)
• No pulmonary hypertension (mean pulmonary artery pressure ≥ 60 mm Hg)
• Not dependent on oxygen

PRIOR CONCURRENT THERAPY:

• See Disease Characteristics
• Prior anthracyclines allowed
• No concurrent dexrazoxane