• Posted January 12, 2024

Drug May Help Childhood Cancer Survivors Avoid Later Heart Failure

Childhood cancer survivors are at increased risk of developing heart failure later in life, due to the chemotherapy that was used to save their lives.

But an already approved drug might help reduce that risk, according to a new report published Jan. 9 in The Lancet Oncology journal.

A blood vessel-relaxing medication called carvedilol is safe for childhood cancer survivors to take and shows promise in reducing the effects of heart injury caused by chemo.

“The growing number of childhood cancer survivors makes the development of early interventions imperative,” said researcher Dr. Saro Armenian, chair of pediatrics at City of Hope Children's Cancer Center in Los Angeles.

“Just helping children survive cancer isn't enough. We also need to optimize patients' health so that they don't have to face life-threatening side effects decades after they are cancer-free,” Armenian added in a City of Hope news release.

The trial focused on a devastating long-term side effect from a class of chemo called anthracyclines -- increased risk of heart failure, in which the heart becomes too weak to pump enough blood to meet the body's needs.

The chemo's damage takes effect gradually over time, as the heart muscle thins and the heart's chambers enlarge.

Unfortunately, the downward cascade is irreversible after heart function starts to decline, making it urgent that means are found to protect childhood cancer survivors before trouble starts.

Carvedilol is a beta blocker used to treat high blood pressure and heart failure. The U.S. Food and Drug Administration approved the drug in 1995, and it is now available as a generic.

The trial involved 182 childhood cancer survivors across the United States and Canada who took relatively low doses of carvedilol or a placebo for two years.

The clinical trial did not achieve its goal of decreasing the thinning of the heart muscle and enlargement of the chambers, results show.

However, there were significant improvements in the wall stress of the heart's left lower chamber, or ventricle, researchers said. This is an earlier biomarker of worsening heart health.

Additionally, more patients on placebo developed clinically significant decline in heart function than those on carvedilol -- six versus two, Armenian said.

“The greatest benefit was seen in participants who were very long-term survivors, as well as in those who were highly adherent to the study medication,” Armenian said.

Overall, the trial “sets the stage for a Phase 3 clinical trial that may demonstrate a significant benefit for certain patients who are at an especially high risk of irreversible heart function decline after completion of cancer therapy,” Armenian said.

More information

The National Cancer Institute has more about the later effects of treatment for childhood cancers.

SOURCE: City of Hope, news release, Jan. 9, 2024