TRUST-ACE - Anticancer-treatment Cardiotoxicity Identification by Echocardiography

NCT ID: NCT06310330

Last Updated: 2025-06-06

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

250 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-03-08

Study Completion Date

2026-12-31

Brief Summary

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TRUST-ACE will compare a simplified echocardiographic protocol focusing on ventricular function with the guideline recommended comprehensive echocardiographic examination using a randomised design in follow-up of breast-cancer patients with respect to identification of cancer treatment related cardiac dysfunction (CTRCD).

Secondly, the study will evaluate whether novel tools used to improve standardization of recordings as well as automated measurements of central measurements, e.g. ejection fraction (EF) and global longitudinal strain (GLS) can improve the precision of echocardiography in daily clinical practice.

Detailed Description

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Cancer treatment related cardiac dysfunction (CTRCD) is a well-known complication to cancer treatment with implication both with respect to treatment and prognosis of the cancer as well as heart.

CTRCD, often named cardiotoxicity, usually refers to myocardial dysfunction and heart failure developing after administration of potentially cardiotoxic therapy. By precise diagnostics, adequate treatment can be started early to prevent heart failure and unnecessary discontinuation of the potential life-saving cancer treatment may be avoided. However, guideline advocated analyses of cardiac function (EF and GLS) by echocardiography are time consuming and many operators base their semi-quantitative estimates on visual assessment. Furthermore, test-retest variability for both EF and GLS are significant and may exceed the guideline recommended cut-offs for identification of cancer therapy-related cardiovascular toxicity.

The study will compare a simplified echocardiographic protocol focusing on ventricular function with the guideline recommended comprehensive echocardiographic examination using a randomized design. The study will also evaluate if novel tools for improved standardization of recordings and automated measurements of relevant measurements as ejection fraction (EF) and global longitudinal strain (GLS) can improve the diagnostic precision.

Breast cancer patients referred for follow-up at the echocardiography will be included.

Patients will be randomized 1:1 to A) examinations with two- and three-dimensional echocardiography including all central measures of cardiac size and function measured by sonographers as recommended by the European guidelines and as clinical practice or B) echocardiographic examinations focusing on the ventricles.

Subpopulations will undergo additional testing with serial echocardiographic examinations by four operators on the same day with and without use of novel tools for improved standardization of recordings and automated measurements.

Conditions

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Breast Neoplasm Malignant Primary

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Randomization 1:1 to two different modes of follow-up
Primary Study Purpose

DIAGNOSTIC

Blinding Strategy

NONE

No masking

Study Groups

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Usual care

Standard of care echocardiographic follow-up

Group Type ACTIVE_COMPARATOR

Comprehensive echocardiographic follow-up

Intervention Type DIAGNOSTIC_TEST

Comprehensive echocardiographic follow-up for identification of CRTCD in breast cancer patients

Simplified care

Simplified echocardiographic follow-up

Group Type EXPERIMENTAL

Simplified echocardiographic follow-up

Intervention Type DIAGNOSTIC_TEST

Simplified echocardiographic follow-up for identification of CRTCD in breast cancer patients

Interventions

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Comprehensive echocardiographic follow-up

Comprehensive echocardiographic follow-up for identification of CRTCD in breast cancer patients

Intervention Type DIAGNOSTIC_TEST

Simplified echocardiographic follow-up

Simplified echocardiographic follow-up for identification of CRTCD in breast cancer patients

Intervention Type DIAGNOSTIC_TEST

Eligibility Criteria

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Inclusion Criteria

* Breast cancer and referral for follow-up to identify potential CTRCD

Exclusion Criteria

* Not willing or able to consent
Minimum Eligible Age

18 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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St. Olavs Hospital

OTHER

Sponsor Role collaborator

Norwegian University of Science and Technology

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Espen Holte, MD, PhD

Role: PRINCIPAL_INVESTIGATOR

St. Olavs Hospital

Locations

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St. Olavs hospital

Trondheim, , Norway

Site Status RECRUITING

Countries

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Norway

Central Contacts

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Espen Holte, MD. PhD

Role: CONTACT

92243119 ext. 47

Havard Dalen, MD, PhD

Role: CONTACT

95871716 ext. 47

Facility Contacts

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Rune Wiseth, MD, PhD

Role: primary

92247845 ext. 47

References

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Sabo S, Pettersen H, Boen GC, Jakobsen EO, Langoy PK, Nilsen HO, Pasdeloup D, Smistad E, Ostvik A, Lovstakken L, Stolen S, Grenne B, Dalen H, Holte E. Real-time guidance and automated measurements using deep learning to improve echocardiographic assessment of left ventricular size and function. Eur Heart J Imaging Methods Pract. 2025 Jul 21;3(2):qyaf094. doi: 10.1093/ehjimp/qyaf094. eCollection 2025 Jul.

Reference Type DERIVED
PMID: 40747448 (View on PubMed)

Other Identifiers

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2019/1059

Identifier Type: -

Identifier Source: org_study_id

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