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Rationale and design of the multidisciplinary team IntervenTion in cArdio-oNcology study (TITAN)

Overview of attention for article published in BMC Cancer, September 2016
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Rationale and design of the multidisciplinary team IntervenTion in cArdio-oNcology study (TITAN)
Published in
BMC Cancer, September 2016
DOI 10.1186/s12885-016-2761-8
Pubmed ID

Edith Pituskin, Mark Haykowsky, Margaret McNeely, John Mackey, Neil Chua, Ian Paterson


Cancer is the leading cause of premature death in Canada. In the last decade, important gains in cancer survival have been achieved by advances in adjuvant treatment. However, many oncologic treatments also result in cardiovascular "toxicity". Furthermore, cardiac risk factors such as hypertension, dyslipidemia, and diabetes mellitus are known to contribute to the progression of cardiac damage and clinical cardiotoxicity. As such, for many survivors, the risk of death from cardiac disease exceeds that of recurrent cancer. While provision of care by multidisciplinary teams has been shown to reduce mortality and hospitalizations among heart failure patients, the effect of assessments and interventions by multidisciplinary specialists in cancer patients receiving cardiotoxic chemotherapy regimens is currently unknown. Accordingly, we will examine the effect of a multi-disciplinary team interventions in the early assessment, identification and treatment of cardiovascular risk factors in cancer patients receiving adjuvant systemic therapy. Our main hypothesis is to determine if the incidence of LV dysfunction in cancer patients undergoing adjuvant therapy can be reduced through a multidisciplinary team approach. This is a randomized study comparing intensive multidisciplinary team intervention to usual care in the prevention of LV remodeling in patients receiving anthracycline or trastuzumab-based chemotherapy. Main objectives include early detection strategies for cardiotoxicity using novel biomarkers that reflect myocardial injury, remodeling and/or dysfunction; early identification and intensive treatment of cardiovascular risk factors; and early intervention with supportive care strategies including nutritional and pharmacist counselling, exercise training and cardiology team support. Secondary objectives include correlation of novel biomarkers to clinical outcomes; correlation of multidisciplinary interventions to adverse clinical outcomes; relationship of multidisciplinary interventions and chemotherapy dose density; preservation of lean muscle mass; and patient reported outcomes (symptom intensity and quality of life). Cardiac toxicity as a result of cancer therapies is now recognized as a significant health problem of increasing prevalence. To our knowledge, TITAN will be the first randomized trial examining the utility of multidisciplinary team care in the prevention of cardiotoxicity. We expect our results to inform comprehensive and holistic care for patients at risk for negative cancer therapy mediated sequelae. ClinicalTrials.gov, NCT01621659 Registration Date 4 June 2012.

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Mendeley readers

The data shown below were compiled from readership statistics for 199 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Canada 1 <1%
Unknown 198 99%

Demographic breakdown

Readers by professional status Count As %
Student > Master 45 23%
Student > Bachelor 24 12%
Researcher 23 12%
Student > Ph. D. Student 17 9%
Student > Postgraduate 12 6%
Other 34 17%
Unknown 44 22%
Readers by discipline Count As %
Medicine and Dentistry 58 29%
Nursing and Health Professions 32 16%
Sports and Recreations 11 6%
Psychology 8 4%
Pharmacology, Toxicology and Pharmaceutical Science 8 4%
Other 31 16%
Unknown 51 26%

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 06 October 2016.
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