# STOP-CA: Statins to prevent Cardiotoxicity from Anthracyclines

> **NIH NIH R01** · MASSACHUSETTS GENERAL HOSPITAL · 2020 · $631,959

## Abstract

7. Project Summary/Abstract
Survival among patients with non-Hodgkin's Lymphoma (NHL) has improved due to a combination of earlier
diagnosis, improved characterization and better treatments. Anthracyclines are an integral part of most
standard chemotherapy regimens for patients with NHL and have contributed to this improved survival.
However, the use of anthracyclines is limited by the well recognized and frequent occurrence of cardiotoxicity,
that manifests itself as a reduction in left ventricular ejection fraction (LVEF) leading to congestive heart failure.
In comparison to other patients receiving anthracycline-based chemotherapy, patients with NHL are at the
highest risk of congestive heart failure. In animal studies, statins reduced myocardial fibrosis and cell death
after anthracyclines and in small clinical studies statins preserved LVEF. Therefore, in this randomized multi-
center placebo-controlled clinical trial, Statins TO Prevent the Cardiotoxicity from Anthracyclines (STOP-CA),
we will determine whether statins preserve LVEF 12 months after the initiation of chemotherapy in 270 patients
with NHL undergoing anthracycline-based chemotherapy. We will test the effect of statin therapy on cardiac
magnetic resonance (CMR)-derived LVEF as CMR-derived LVEF is the gold-standard for non-invasive
measurement of LVEF. All measurements will be performed in a core imaging laboratory by expert reviewers
blinded to all other data using a standardized protocol. This study is not powered to detect a difference in
clinical events; however, as statin therapy has been shown retrospectively to reduce heart failure
hospitalizations, and this will be a key goal of subsequent studies, we will capture this data. We also propose
to use the additive tissue characterization available with CMR imaging to test the effect of statin therapy on
anthracycline-induced myocardial fibrosis and whether fibrosis predicts the decrease in LVEF. Finally, we will
use myocardial strain (a sensitive index of cardiac function) measured using echocardiography and plasma
levels of troponin (reflecting myocardial injury), both widely available and scalable parameters, to identify early
during treatment NHL patients at high risk of LVEF decline and to test whether statin therapy has beneficial
effects on myocardial injury and early LV dysfunction. At the completion of this proposal, we will have
characterized the effect of statins on anthracycline-induced LV dysfunction in patients with NHL, established
their safety and identified patients with NHL at high risk of cardiotoxicity.

## Key facts

- **NIH application ID:** 9991891
- **Project number:** 5R01HL130539-05
- **Recipient organization:** MASSACHUSETTS GENERAL HOSPITAL
- **Principal Investigator:** Tomas G Neilan
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $631,959
- **Award type:** 5
- **Project period:** 2016-09-15 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9991891

## Citation

> US National Institutes of Health, RePORTER application 9991891, STOP-CA: Statins to prevent Cardiotoxicity from Anthracyclines (5R01HL130539-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9991891. Licensed CC0.

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