A new nuclear imaging technique may help identify women at increased risk of heart damage due to their cancer treatment. The new imaging test uses the radiotracer technetium-99 labelled Annexin V, which was developed by Atreus, an Ottawa-based company that was later acquired by Advanced Accelerator Applications, a developer of innovative radiopharmaceuticals. Annexin is an investigational radiotracer and currently has been approved only for investigational use.

Heart damage (cardiotoxicity) is a known risk for women treated with chemotherapy for early stage breast cancer. As breast cancer treatment has become more successful, more women are surviving a breast cancer diagnosis. However, there can be short- and long-term toxicities (side effects) from cancer treatments. Heart disease is now the second leading cause of death for postmenopausal breast cancer survivors and one of the contributing factors may be the cancer treatment they received. In some cases (2–3 percent), breast cancer survivors may develop heart failure during or following completion of their cancer therapy.

Preclinical studies have shown that this new imaging technique, using the radiotracer Annexin, can identify early damage to the heart muscle. Early detection could allow for cancer therapy to be modified to limit damage to the heart and prevent the development of heart failure.

The University of Ottawa Heart Institute (UOHI) and The Ottawa Hospital have recently launched a clinical trial to assess the use of a novel imaging test in breast cancer patients undergoing chemotherapy. The trial, 99mTc-rhAnnexin V-128 Imaging of Apoptosis and Cardiotoxicity in Relationship to Ventricular Function in Patients with Early Stage Breast Cancer Receiving Doxorubicin-Based Chemotherapy, has enrolled eight patients with a total of 30 patients planned. Women with newly diagnosed early stage breast cancer interested in participating in the study should contact their oncologist for more information.

This study, the first in the world, is led by Dr. Terrence Ruddy at UOHI and Dr. Susan Dent of The Ottawa Hospital Cancer Centre. Dr. Ruddy is past chair of the Division of Cardiology at UOHI, past chair of Nuclear Medicine at the University of Ottawa and president-elect of the Cardiovascular Council of the Society of Nuclear Medicine and Molecular Imaging. Dr. Dent is founder of the Ottawa Cardiac Oncology program and founder and president of the Canadian Cardiac Oncology Network.

This study (NCT02677714) is registered on clinicaltrials.gov and is funded by Advanced Accelerator Applications, with support from the Ontario Research Fund.

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