Take charge during treatment: a protocol for a pilot study to evaluate the impact of exercise on cardiovascular biomarkers among black and white breast cancer patients undergoing treatment. Cardiooncology 2025 Aug 21;11(1):75
Date
08/22/2025Pubmed ID
40841694Pubmed Central ID
PMC12369258DOI
10.1186/s40959-025-00378-7Scopus ID
2-s2.0-105014033548 (requires institutional sign-in at Scopus site)Abstract
Cardiotoxicity is a significant challenge associated with common first-line breast cancer (BC) anti-neoplastic (CTx) treatments including anthracyclines (AC) and targeted immunotherapies, such as anti-Her-2 therapy. Non-Hispanic black/African American (NHB) women are at higher risk for CTx induced cardiotoxicity compared to Non-Hispanic White (NHW) women. To date, most study efforts to mitigate cardiotoxicity target large vessels and cardiac damage. However, impaired microvascular function may also be implicated. Further, although exercise interventions reduce systemic inflammation and cardiovascular risk, few cardio-oncology studies examine the effect of exercise on CTx cardiotoxicity, and none have quantified microvascular endothelial function. An additional gap is the paucity of studies focused on racial disparities. The Discovery and Elimination of Cardio-Oncology Disparities for Equity in the Heartland (DECODE Heartland) Center addresses these gaps with three overarching goals to: (1) Test the feasibility and efficacy of the Take Charge during Treatment (TCT) exercise intervention designed to mitigate the adverse effects of CTx; (2) Quantify differences on exercise capacity and quality of life (QoL), endothelial function and molecular differences in inflammation in NHB versus NHW BC patients before and following CTx; and (3) Examine the influence of socio-ecological factors (individual, interpersonal, systemic, environmental) on inflammation, microvascular endothelial function, QoL in response to the exercise intervention. NHB and NHW women diagnosed with non-metastatic BC, scheduled to receive AC and/or anti-Her2 therapy, will be recruited and randomized to participate in the TCT intervention or usual care. TCT is a virtual exercise program with weekly coaching sessions, six of which include supervised exercise. Assessments include surveys, dual X-ray absorptiometry, flow-mediated dilation, pulse wave velocity and analysis, VO2 peak cycling test, fat biopsy, venous puncture blood draw, geocoding of patient addresses, and measurement of neighborhood characteristics. Assessments will be captured prior to treatment, post-intervention (16-20 weeks), and at follow-up/study completion (12-18 months post-diagnosis). This study reflects a first step in a research trajectory to identify upstream determinants of disparities and discern how behavioral strategies can assist diverse BC survivors to move through treatment toward better health, including reduced rates of cardiotoxicity following anti-cancer treatment.
Author List
Do Couto N, Hidde M, Grigoriadis G, Sparapani R, Durand M, Widlansky M, Jankowski C, Berendt M, Canales B, Golus S, Norwood Toro LE, Laud P, Kong A, Hoskins K, Lewandowski D, Phillips SA, Gutterman DD, Kriegel AJ, Beyer KMM, Beyer AM, Stolley MAuthors
Kirsten M. Beyer PhD, MPH Professor in the Institute for Health and Humanity department at Medical College of WisconsinAndreas M. Beyer PhD Professor in the Medicine department at Medical College of Wisconsin
Amanda L. Kong MD, MS Professor in the Surgery department at Medical College of Wisconsin
Purushottam W. Laud PhD Adjunct Professor in the Data Science Institute department at Medical College of Wisconsin
David Lewandowski MD Assistant Professor in the Medicine department at Medical College of Wisconsin
Rodney Sparapani PhD Associate Professor in the Data Science Institute department at Medical College of Wisconsin
Melinda Stolley PhD Center Associate Director, Professor in the Medicine department at Medical College of Wisconsin
Michael E. Widlansky MD Center Director, Interim Chief, Professor in the Medicine department at Medical College of Wisconsin
