Multidisciplinary Team IntervenTion in CArdio-ONcology (TITAN Study)

People with breast cancer often experience many short and long-term side effects as a result of both the cancer and the necessary treatments. Receiving extra assessments and care from teams of multiple health professionals has been shown to be helpful for people with other health problems, such as heart disease. These 'multidisciplinary' teams may include nurses, doctors, pharmacists, dietitians, exercise therapists, counselors, and other specialists. Currently, the investigators do not know if receiving extra assessments from a multidisciplinary team is helpful for people receiving cancer treatment. In this study, the investigators hope to learn the effect of extra assessments and early interventions from teams of health care professionals in people diagnosed with cancer, during and after the treatment period. After initial assessments, participants will be randomized to multidisciplinary team intervention or usual care.

Sex

All

Minimum age

18 Years

Inclusion Criteria:

* histologically confirmed malignancy (breast or lymphoma);
* scheduled to receive anthracycline and/or trastuzumab-based chemotherapy;
* age ≥ 18 years;
* willing to attend follow-up visits.

Exclusion Criteria:

* physical disability preventing exercise testing or DEXA scan;
* psychiatric disease or disorder precluding informed consent;
* participation in other cardiotoxicity or exercise intervention study;
* contraindication to anti-cancer therapy, including known heart failure, cardiomyopathy, or baseline LVEF \< 50%;
* previous anthracycline or trastuzumab-based therapy;
* previous radiotherapy to thorax.

• DERIVEDKirkham AA, Mackey JR, Thompson RB, Haykowsky MJ, Oudit GY, McNeely M, Coulden R, Stickland MK, Baracos VE, Dyck JRB, Haennel R, Pituskin E, Paterson DI. TITAN Trial: A Randomized Controlled Trial of a Cardiac Rehabilitation Care Model in Breast Cancer. JACC Adv. 2023 Jul 27;2(6):100424. doi: 10.1016/j.jacadv.2023.100424. eCollection 2023 Aug. PMID 38939428
• DERIVEDMaayah ZH, Ferdaoussi M, Boukouris AE, Takahara S, Das SK, Khairy M, Mackey JR, Pituskin E, Sutendra G, Paterson DI, Dyck JRB. Endothelin Receptor Blocker Reverses Breast Cancer-Induced Cardiac Remodeling. JACC CardioOncol. 2023 May 2;5(5):686-700. doi: 10.1016/j.jaccao.2023.02.004. eCollection 2023 Oct. PMID 37969640
• DERIVEDPituskin E, Haykowsky M, McNeely M, Mackey J, Chua N, Paterson I. Rationale and design of the multidisciplinary team IntervenTion in cArdio-oNcology study (TITAN). BMC Cancer. 2016 Sep 15;16(1):733. doi: 10.1186/s12885-016-2761-8. PMID 27629548