search
Back to results

A Study of Vericiguat in People With Breast Cancer and Cancer Therapy-Related Cardiac Dysfunction

Primary Purpose

Breast Cancer, Cardiac Dysfunction

Status
Recruiting
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Vericiguat
Optimal medical therapy
Sponsored by
Memorial Sloan Kettering Cancer Center
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Breast Cancer focused on measuring Vericiguat, Cancer Therapy-Related Cardiac Dysfunction (CTRCD), 23-050

Eligibility Criteria

18 Years - undefined (Adult, Older Adult)FemaleDoes not accept healthy volunteers

Inclusion Criteria: Age ≥ 18 years Biopsy proven breast cancer (stage I-IV) Cancer treatment related cardiac dysfunction (CTRCD), established by an absolute decrease in LVEF ≥ 10% from baseline/pre-treatment to < 53% and attributable to prior cardiotoxic cancer treatment, per the clinical investigator. Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria: Achieving a plateau oxygen consumption, concurrent with an increase in power output; A respiratory exchange ratio ≥ 1.10; Attainment of maximal predicted heart rate, as defined by a peak heart rate within 10bpm of the age predicted maximal heart rate (220 - Age[years]); Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale. Willing to use highly effective contraceptive measures if of child-bearing potential or if the patient's sexual partner is a woman of child-earing potential while receiving study drug and for 30 days after the last dose of study drug: Female subjects should be using highly effective contraceptive measures, and must have a negative pregnancy test and not be breast-feeding prior to start of dosing if of child-bearing potential or must have evidence of non-child-bearing potential by fulfilling one of the following criteria at screening: Post-menopausal defined as aged more than 50 years and amenorrheic for at least 12 months following cessation of all exogenous hormonal treatments Women under 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and with LH and FSH levels in the postmenopausal range for the institution Documentation of irreversible surgical sterilization by hysterectomy, bilateral oophorectomy or bilateral salpingectomy, but not tubal ligation. Male subjects should be willing to use barrier contraception °Willing and able to comply with the requirements of the protocol. Exclusion Criteria: Systolic blood pressure < 90 mmHg Concurrent or anticipated use of a long-acting nitrate or NO donor (e.g., nitroglycerin, isosorbide dinitrate, isosorbide 5-mononitrate, pentaerythritol tetranitrate, nicorandil or transdermal NTG patch, or molsidomine). Concurrent or anticipated use of a phosphodiesterase inhibitor (e.g., vardenafil, tadalafil, or sildenafil). Cardiac comorbidity, including any of the following: Hypertrophic cardiomyopathy, restrictive cardiomyopathy, active myocarditis, constrictive pericarditis, cardiac sarcoidosis, or amyloid cardiomyopathy Uncontrolled arrhythmia Uncorrected congenital cardiac disease Acute coronary syndrome, percutaneous coronary intervention, or coronary artery bypass graft surgery within 3 months prior to randomization. Symptomatic carotid stenosis, or transient ischemic attack (TIA) or stroke within 3 months prior to randomization. Cardiac transplantation Valvular heart disease requiring surgery or intervention Non-cardiac comorbidity, including any of the following: eGFR < 15ml/min/1.73m^2 (based upon CKD-EPI, Cockroft-Gault, etc.) Severe hepatic insufficiency (e.g., Child-Pugh C) Severe pulmonary disease, such as requiring continuous home oxygen or interstitial lung disease Other medical disorder or condition that in the opinion of the investigator would impair the subject's ability to participate or complete the study Subjects must not have any of the following absolute contraindications to cardiopulmonary exercise testing: Acute myocardial infarction (within 30 days of any planned study procedures) Unstable angina Uncontrolled arrhythmias causing symptoms or hemodynamic compromise, Symptomatic severe aortic stenosis Recurrent syncope Active endocarditis Acute myocarditis or pericarditis Acute pulmonary embolus or pulmonary infarction (within 3 months of any planned study procedures) Thrombosis of lower extremities (within 3 months of any planned study procedures) Suspected dissecting aneurysm Uncontrolled asthma Pulmonary edema Room air desaturation at rest ≤85% Respiratory failure Acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis) Mental impairment leading to inability to cooperate. Current alcohol and/or drug abuse Any other condition or intercurrent illness (e.g., symptomatic weight-bearing bone metastases or limited life expectancy < 6-9 months) that, in the opinion of the investigator, makes the participant a poor candidate for the trial

Sites / Locations

  • Memorial Sloan Kettering Cancer Center (All Protocol Activities)Recruiting

Arms of the Study

Arm 1

Arm 2

Arm Type

Experimental

Active Comparator

Arm Label

Vericiguat plus optimal medical therapy

Optimal medical therapy

Arm Description

For patients randomized to vericiguat, a starting dose of 2.5mg will be initiated at the randomization visit. At pre-specified titration visits, subjects will be up-titrated to vericiguat 5mg and then to the target dose of vericiguat 10mg using titration criteria based on mean systolic blood pressure and evaluation for clinical symptoms. Vericiguat will be administered in the background of optimal medical therapy for cardiomyopathy/heart failure.

For patients randomized to the control group, optimal medical therapy for cardiomyopathy/heart failure will be instituted throughout the study period.

Outcomes

Primary Outcome Measures

change in CRF (measured by VO2peak)
For the primary analysis, intervention effect will be evaluated by comparing differences in mean VO2peak changes from baseline to month 6 between the investigational and control groups using the analysis of covariance approach (ANCOVA).

Secondary Outcome Measures

CRF response rate
assessed by the number of participants with a change in VO2peak ≥ 1.32 ml O2 • kg-1 • min-1 (technical error of CRF measurement) from baseline to month 6. A change in VO2peak ≥ 1.32 ml O2 • kg-1 • min-1 will be considered a response, whereas a change in VO2peak < 1.32 ml O2 • kg-1 • min-1 will be considered a non-response.

Full Information

First Posted
March 28, 2023
Last Updated
July 17, 2023
Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
Merck Sharp & Dohme LLC
search

1. Study Identification

Unique Protocol Identification Number
NCT05806138
Brief Title
A Study of Vericiguat in People With Breast Cancer and Cancer Therapy-Related Cardiac Dysfunction
Official Title
A Randomized Controlled Trial of the Soluble Guanylate Cyclase Stimulator Vericiguat in Patients With Breast Cancer and Cancer Therapy-Related Cardiac Dysfunction (ELEVATE)
Study Type
Interventional

2. Study Status

Record Verification Date
July 2023
Overall Recruitment Status
Recruiting
Study Start Date
July 17, 2023 (Actual)
Primary Completion Date
July 17, 2028 (Anticipated)
Study Completion Date
July 17, 2028 (Anticipated)

3. Sponsor/Collaborators

Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Memorial Sloan Kettering Cancer Center
Collaborators
Merck Sharp & Dohme LLC

4. Oversight

Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Product Manufactured in and Exported from the U.S.
No

5. Study Description

Brief Summary
The purpose of this study is to find out if adding vericiguat to standard treatment for cancer therapy related cardiac dysfunction (CTRCD) is more effective than standard treatment alone. The addition of vericiguat to the usual treatment could help improve cardiac function, but it could also cause side effects. This study will help researchers find out whether this different treatment is better, the same as, or worse than the usual approach.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Breast Cancer, Cardiac Dysfunction
Keywords
Vericiguat, Cancer Therapy-Related Cardiac Dysfunction (CTRCD), 23-050

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 2
Interventional Study Model
Parallel Assignment
Model Description
This is a single center, open-label, randomized controlled trial of vericiguat in adult patients with breast cancer and Cancer Therapy-Related Cardiac Dysfunction (CTRCD).
Masking
None (Open Label)
Allocation
Randomized
Enrollment
50 (Anticipated)

8. Arms, Groups, and Interventions

Arm Title
Vericiguat plus optimal medical therapy
Arm Type
Experimental
Arm Description
For patients randomized to vericiguat, a starting dose of 2.5mg will be initiated at the randomization visit. At pre-specified titration visits, subjects will be up-titrated to vericiguat 5mg and then to the target dose of vericiguat 10mg using titration criteria based on mean systolic blood pressure and evaluation for clinical symptoms. Vericiguat will be administered in the background of optimal medical therapy for cardiomyopathy/heart failure.
Arm Title
Optimal medical therapy
Arm Type
Active Comparator
Arm Description
For patients randomized to the control group, optimal medical therapy for cardiomyopathy/heart failure will be instituted throughout the study period.
Intervention Type
Drug
Intervention Name(s)
Vericiguat
Intervention Description
A starting dose of vericiguat 2.5 mg will be administered in-clinic at the Day 1 visit. Titration visits will occur on Days 14 and 28, with dose escalation to 5 mg and 10 mg.
Intervention Type
Other
Intervention Name(s)
Optimal medical therapy
Intervention Description
All subjects will be followed by a cardiologist throughout the study period and will receive optimal medical therapy for cardiomyopathy/heart failure following the ACCF/AHA and ESC Guidelines for the Management of Heart Failure recommendations, applied individually at the discretion of the treating investigator and in line with individual tolerability. This includes medications such as ßblockers, angiotensin converting enzyme inhibitors(ACEI), angiotensin receptor/neprilysin inhibitor (ARNI), angiotensin receptor blockers (ARB), and mineralocorticoid antagonists
Primary Outcome Measure Information:
Title
change in CRF (measured by VO2peak)
Description
For the primary analysis, intervention effect will be evaluated by comparing differences in mean VO2peak changes from baseline to month 6 between the investigational and control groups using the analysis of covariance approach (ANCOVA).
Time Frame
up to 6 months
Secondary Outcome Measure Information:
Title
CRF response rate
Description
assessed by the number of participants with a change in VO2peak ≥ 1.32 ml O2 • kg-1 • min-1 (technical error of CRF measurement) from baseline to month 6. A change in VO2peak ≥ 1.32 ml O2 • kg-1 • min-1 will be considered a response, whereas a change in VO2peak < 1.32 ml O2 • kg-1 • min-1 will be considered a non-response.
Time Frame
up to 6 months

10. Eligibility

Sex
Female
Gender Based
Yes
Gender Eligibility Description
Breast cancer
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Age ≥ 18 years Biopsy proven breast cancer (stage I-IV) Cancer treatment related cardiac dysfunction (CTRCD), established by an absolute decrease in LVEF ≥ 10% from baseline/pre-treatment to < 53% and attributable to prior cardiotoxic cancer treatment, per the clinical investigator. Able to complete an acceptable baseline CPET, in the absence of high-risk ECG findings or other inappropriate response to exercise as determined by the PI, as defined by any of the following criteria: Achieving a plateau oxygen consumption, concurrent with an increase in power output; A respiratory exchange ratio ≥ 1.10; Attainment of maximal predicted heart rate, as defined by a peak heart rate within 10bpm of the age predicted maximal heart rate (220 - Age[years]); Volitional exhaustion, as measured by a rating of perceived exertion (RPE) ≥ 18 on the BORG scale. Willing to use highly effective contraceptive measures if of child-bearing potential or if the patient's sexual partner is a woman of child-earing potential while receiving study drug and for 30 days after the last dose of study drug: Female subjects should be using highly effective contraceptive measures, and must have a negative pregnancy test and not be breast-feeding prior to start of dosing if of child-bearing potential or must have evidence of non-child-bearing potential by fulfilling one of the following criteria at screening: Post-menopausal defined as aged more than 50 years and amenorrheic for at least 12 months following cessation of all exogenous hormonal treatments Women under 50 years old would be considered postmenopausal if they have been amenorrheic for 12 months or more following cessation of exogenous hormonal treatments and with LH and FSH levels in the postmenopausal range for the institution Documentation of irreversible surgical sterilization by hysterectomy, bilateral oophorectomy or bilateral salpingectomy, but not tubal ligation. Male subjects should be willing to use barrier contraception °Willing and able to comply with the requirements of the protocol. Exclusion Criteria: Systolic blood pressure < 90 mmHg Concurrent or anticipated use of a long-acting nitrate or NO donor (e.g., nitroglycerin, isosorbide dinitrate, isosorbide 5-mononitrate, pentaerythritol tetranitrate, nicorandil or transdermal NTG patch, or molsidomine). Concurrent or anticipated use of a phosphodiesterase inhibitor (e.g., vardenafil, tadalafil, or sildenafil). Cardiac comorbidity, including any of the following: Hypertrophic cardiomyopathy, restrictive cardiomyopathy, active myocarditis, constrictive pericarditis, cardiac sarcoidosis, or amyloid cardiomyopathy Uncontrolled arrhythmia Uncorrected congenital cardiac disease Acute coronary syndrome, percutaneous coronary intervention, or coronary artery bypass graft surgery within 3 months prior to randomization. Symptomatic carotid stenosis, or transient ischemic attack (TIA) or stroke within 3 months prior to randomization. Cardiac transplantation Valvular heart disease requiring surgery or intervention Non-cardiac comorbidity, including any of the following: eGFR < 15ml/min/1.73m^2 (based upon CKD-EPI, Cockroft-Gault, etc.) Severe hepatic insufficiency (e.g., Child-Pugh C) Severe pulmonary disease, such as requiring continuous home oxygen or interstitial lung disease Other medical disorder or condition that in the opinion of the investigator would impair the subject's ability to participate or complete the study Subjects must not have any of the following absolute contraindications to cardiopulmonary exercise testing: Acute myocardial infarction (within 30 days of any planned study procedures) Unstable angina Uncontrolled arrhythmias causing symptoms or hemodynamic compromise, Symptomatic severe aortic stenosis Recurrent syncope Active endocarditis Acute myocarditis or pericarditis Acute pulmonary embolus or pulmonary infarction (within 3 months of any planned study procedures) Thrombosis of lower extremities (within 3 months of any planned study procedures) Suspected dissecting aneurysm Uncontrolled asthma Pulmonary edema Room air desaturation at rest ≤85% Respiratory failure Acute noncardiopulmonary disorder that may affect exercise performance or be aggravated by exercise (i.e., infection, renal failure, thyrotoxicosis) Mental impairment leading to inability to cooperate. Current alcohol and/or drug abuse Any other condition or intercurrent illness (e.g., symptomatic weight-bearing bone metastases or limited life expectancy < 6-9 months) that, in the opinion of the investigator, makes the participant a poor candidate for the trial
Central Contact Person:
First Name & Middle Initial & Last Name or Official Title & Degree
Anthony Yu, MD
Phone
212-639-7932
Email
yua3@mskcc.org
First Name & Middle Initial & Last Name or Official Title & Degree
Jennifer Liu, MD
Phone
212-639-8220
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Anthony Yu, MD, MS
Organizational Affiliation
Memorial Sloan Kettering Cancer Center
Official's Role
Principal Investigator
Facility Information:
Facility Name
Memorial Sloan Kettering Cancer Center (All Protocol Activities)
City
New York
State/Province
New York
ZIP/Postal Code
10065
Country
United States
Individual Site Status
Recruiting
Facility Contact:
First Name & Middle Initial & Last Name & Degree
Anthony Yu, MD
Phone
212-639-7932

12. IPD Sharing Statement

Plan to Share IPD
Yes
IPD Sharing Plan Description
Memorial Sloan Kettering Cancer Center supports the international committee of medical journal editors (ICMJE) and the ethical obligation of responsible sharing of data from clinical trials. The protocol summary, a statistical summary, and informed consent form will be made available on clinicaltrials.gov when required as a condition of Federal awards, other agreements supporting the research and/or as otherwise required. Requests for deidentified individual participant data can be made beginning 12 months after publication and for up to 36 months post publication. Deidentified individual participant data reported in the manuscript will be shared under the terms of a Data Use Agreement and may only be used for approved proposals. Requests may be made to: crdatashare@mskcc.org.
Links:
URL
http://www.mskcc.org/mskcc/html/44.cfm
Description
Memorial Sloan Kettering Cancer Center

Learn more about this trial

A Study of Vericiguat in People With Breast Cancer and Cancer Therapy-Related Cardiac Dysfunction

We'll reach out to this number within 24 hrs