Anthracycline-induced Cardiac ToxicityRESILIENCENCT05223413
REmote iSchemic condItioning in Lymphoma PatIents REceiving ANthraCyclinEs
A study testing RIPC in people with Anthracycline-induced Cardiac Toxicity and Lymphoma, run by Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III at 24 sites in 6 countries.
Trial summary
Multinational, prospective, proof of concept phase II, double-blinded, sham-controlled, randomized clinical trial (RCT) to evaluate the efficacy and safety of Remote Ischaemic PreConditioning (RIPC) in Lymphoma patients receiving anthracyclines. Read more about this study
- Who is it for?
- Ages 18 to 99 years
- Conditions the study is for
- Anthracycline-induced Cardiac Toxicity, Lymphoma
- What is being tested?
- RIPC
- Type of treatment
- Medical device
- Could I receive a placebo?
- Yes, some participants may receive a placebo
- How many people
- 608 participants
- Where
- 24 sitesin 6 countries
- Study dates
- 18 Jan 2022to Dec 2027
- Phase
- Interventional
- Are there results?
- Not yet: the study is under way
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 99 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- ≥18 years old NHL, HL or breast cancer diagnosis Scheduled to undergo chemotherapy including ≥ 240 mg/k2 cumulative dose of anthracyclines.
- Pre-chemo LVEF >40% on screening echocardiography.
- Presence of ≥1 of the following risk factors for developing cardiotoxicity:
- Previous coronary artery disease (any of the following):
- Previous coronary revascularisation (PCI or CABG) or Medical history of previous significant nonrevascularized coronary stenosis Previous Acute Coronary Syndrome / Acute Myocardial Infarction with a LVEF > 40 LVEF 41-54% Age ≥ 65 years old Previous diagnosis of arterial hypertension (with or without treatment) Chronic kidney disease (estimated glomerular filtration rate <60ml/min/1.73m2) Current or former smoker. Obesity (BMI≥30 kg/m2) LVH on screening echocardiography (LV thickness ≥12mm). High alcohol intake (≥21 alcoholic beverages per week) Sinus rhythm on screening ECG Previous diagnosis of diabetes (except those treated with sulfonylureas or those with neuropathy) Previous non-anthracycline-based chemotherapy Signed Informed Consent Form (ICF)
Who cannot join
- History of any of the following diseases:
- Any cancer who received anthracyclines treatment before the index episode.
- Previous clinical diagnosis of heart failure.
- Permanent atrial fibrillation (AF).
- Severe valvular or sub-valvular heart disease.
- Severe peripheral arterial disease in the upper extremities or arteriovenous (AV) shunt in the arm selected for RIPC.
Show all 14Show fewer
- Clinical diagnosis of diabetes neuropathy
- Contraindication for CMR:
- Severe claustrophobia.
- Any device which is known to threaten or pose hazard in all MR environments (http://www.mrisafety.com/).
- Patients with implanted biomedical cardiac devices: pacemakers, ICDs or CRT.
- Severe thrombocytopenia (platelets <50,000/µL) on any blood test within the previous 3 months.
- Patients participating in other clinical trials.
- Impossibility to consent or undergo study follow-ups.
Trial locations and contacts
24 sites in 6 countries. Contact the study team or a site near you to ask about taking part.
24 sites in 6 countries
Spain17 sites, 17 recruiting
- Not yet recruiting
Hospital Universitario Príncipe de Asturias
Alcalá de Henares
Julio García Suarez
- Recruiting
Centro Medico Teknon
Barcelona
Antonio Berruezo
- Recruiting
Instituto Catalán de Oncología
Barcelona
Eva Gonzalez
- Recruiting
Hospital Universitario Virgen de las Nieves
Granada
Jose Manuel Puerta
- Recruiting
Centro Nacional de Investigaciones Cardiovasculares (CNIC)
Madrid
Borja Ibañez
- Recruiting
Fundacion Jimenez Diaz
Madrid
Raul Córdoba
- Recruiting
Hospital General Universitario Gregorio Marañon
Madrid
Mariana Bastos
- Recruiting
Hospital Infanta Leonor
Madrid
Jose Angel Hernandez Rivas
- Recruiting
Hospital Puerta de Hierro
Madrid
Belen Navarro
- Recruiting
Hospital Universitario 12 de Octubre
Madrid
Ana Jimenez
- Recruiting
Hospital Universitario Clínico San Carlos
Madrid
Celina Benavente
- Recruiting
Hospital Universitario la Paz
Madrid
Miguel Canales
- Recruiting
Hospital Universitario Ramon y Cajal
Madrid
Javier Lopez
- Recruiting
Hospital Universitario Ruber Juan Bravo
Madrid
Aranzazu Alonso Alonso
- Recruiting
Hospital Universitario de Salamanca
Salamanca
Alejandro Martin
- Recruiting
Hospital Universitario Virgen del Rocío
Seville
Guillermo Rodriguez
- Recruiting
Hospital Clinico Universitario de Valladolid
Valladolid
Maria Jesús Peñarrubia
France2 sites, 2 recruiting
- Not yet recruiting
Hospital Jaques Monod, El Havre
Montivilliers
Pierre Lebreton
- Recruiting
Henri Becquerel
Rouen
Vincent Camus
Portugal2 sites, 2 recruiting
- Recruiting
Hospital da Luz Learning Health (GLSMED)
Lisbon
Antonio Ferreira
- Recruiting
IPO Lisboa
Lisbon
Maria Gomes
Denmark1 site, 1 recruiting
- Recruiting
Aarhus University
Aarhus
Francesco Damore
Germany1 site, 1 recruiting
- Recruiting
University Hospital Duesseldorf UDUS
Düsseldorf
Florian Boenner
Malte Kelm
Netherlands1 site, 1 recruiting
- Not yet recruiting
Amsterdam UMC
Amsterdam
Marie Jose Kersten
About this study
Multinational, prospective, proof of concept phase II, double-blinded, sham-controlled, randomized clinical trial (RCT) to evaluate the efficacy and safety of Remote Ischaemic PreConditioning (RIPC) in Lymphoma patients receiving anthracyclines.
Read the detailed description
Multinational, prospective, proof of concept phase II, double-blinded, sham-controlled, randomized clinical trial (RCT) to evaluate the efficacy and safety of Remote Ischaemic PreConditioning (RIPC) in lymphoma patients receiving anthracyclines. Patients scheduled to undergo ≥5 chemotherapy cycles will be eligible. Patients fulfilling all inclusion and no exclusion criteria will be enrolled and undergo baseline Cardiac Magnetic Baseline (CMR), and high sensitivity troponin (hsTn) and NT-proBNP blood test. Patients with confirmed LVEF >40% by CMR will be randomized 1:1 to RIPC vs simulated RIPC (Sham). After the third chemotherapy cycle, a second CMR+ hsTn/ NT-proBNP will be performed for the validation of the early marker of cardiotoxicity. A third hsTn/ NT-proBNP blood test will be performed in the last chemotherapy cycle. Nine weeks after finishing chemotherapy, a last CMR+ hsTn/ NT-proBNP will be performed. Patients will be followed-up for clinical events at 6, 12, 18, 30 and 42 months until the last patient undergoes the final CMR. When the last patient undergoes the third CMR, the follow-up will be closed. The median follow-up estimation for clinical endpoints is 36 months (range: 6 to 60 months).
- Conditions
- Anthracycline-induced Cardiac Toxicity, Lymphoma
- Being tested
- RIPC, Simulated RIPC (Sham)
- Medical subject headings
- Lymphoma
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
RIPCDevice
The procedure will be performed by using an electric auto-control device (modified blood pressure monitor for remote ischemic conditioning, Seagull Healthcare Aps, Denmark) for Remote Ischemic Conditioning in the arm. During the inflation period, the blood pressure cuff is inflated to 200 mmHg to stop blood flow in the arm.
Simulated RIPC (Sham)Device
The procedure will be performed by using an electric auto-control device (modified blood pressure monitor for remote ischemic conditioning, Seagull Healthcare Aps, Denmark) for Remote Ischemic Conditioning in the arm. During the inflation period, the blood pressure cuff is inflated to a low pressure not stopping blood flow in the arm.
| Study group | Role | What they receive |
|---|---|---|
| Remote Ischemic Conditioning | Active comparator | Remote Ischemic Conditioning (RIC): Patients will undergo weekly RIC during the entire span of the chemotherapy period. Each RIC session will include four cycles of 5 min blood pressure cuff inflation followed by 5 min deflation Receives: Device: RIPC |
| simulated RIPC (Sham) | Sham comparator | Control group (Sham): Patients will undergo weekly simulated RIC (sham) during the entire span of the chemotherapy period. Each sham session will include four cycles of 5 min blood pressure cuff inflation followed by 5 min deflation. Receives: Device: Simulated RIPC (Sham) |
What is being measured
The primary outcome is the main question the study is designed to answer.
Rate of anthracycline-induced cardiotoxicity events
Cardiotoxicity event is defined as one of the following:
- Drop in LVEF between study CMRs of ≥10 absolute points regardless the absolute value of follow- up ejection fraction (EF).
- Drop in LVEF between study CMRs of ≥5 to <10 absolute points with a follow-up EF value <50%
UNITS: absolute number of patients in each arm qualifying for cardiotoxicity event (i.e. each patient will be qualified at the end of the study as YES/NO).
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Secondary outcomes (6)
Primary efficacy endpoint: (RIC vs Sham) Absolute change in LVEF
change in LVEF between baseline and any follow-up CMRs, whichever shows worse LVEF
UNITS: LVEF is expressed as % LVEF= (LV end-diastolic volume - LV end-systolic volume) / LV end-systolic volume), %
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Rate of tumor regression.
Response to chemotherapy
UNITS: absolute number of patients in each arm qualifying as responder or no responder (i.e. each patient will be qualified at the end of the study as YES/NO).
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Haematological Malignancy Patient-Reported Outcome Measure questionnaire
Haematological Malignancy Patient-Reported Outcome Measure (HM-PRO) questionnaire
UNITS: absolute points in the questionnaire. minimum value 0 maximum value 84
the higher the total score, the better (greater the effect on a patient's QoL)
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Euro Quality of Life-5 dimensions questionnaire
Euro Quality of Life-5 dimensions (EuroQoL-5D) questionnaire:
UNITS: absolute points in the questionnaire. minimum value 0 maximum value 100
the higher the total score, the better (greater the effect on a patient's QoL)
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Kansas City Cardiomyopathy Questionnaire
Kansas City Cardiomyopathy Questionnaire (KCCQ-12)
UNITS: absolute points in the questionnaire. minimum value 0 maximum value 65
the higher the total score, the better (greater the effect on a patient's QoL)
Measured: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Rate of Heart Failure Hospitalization
Rate of Heart Failure Hospitalization
UNITS: Absolute number of patients in each arm experiencing a heart failure hospitalization
Measured: 4-60 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted4 Feb 2022
- Study start18 Jan 2022
- Primary completionJun 2027 (estimated)
- Study completionDec 2027 (estimated)
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Other trials for Anthracycline-induced Cardiac ToxicityStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Model description
- Randomization (1:1) will be stratified by LVEF on baseline CMR (as quantified by CMR core lab /CNIC), by research Centre and by patient's gender.
- Masking
- Quadruple blind
- Who is masked
- Participant, Care provider, Investigator, Outcomes assessor
- Enrolment
- 608 participants (estimated)
Sponsor and investigators
- Lead sponsor
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III
- Sponsor type
- University, hospital or other
- Collaborators
- European Commission
- Responsible party
- Sponsor
- Investigators
- Borja Ibañez, MD PhD FESC, Principal investigator, CNIC
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05223413
- Sponsor's protocol ID
- RESILIENCE-H2020
- Acronym
- RESILIENCE
- Status last verified
- Oct 2026
- First submitted
- 20 Dec 2021
- Last updated
- 29 Oct 2026
- Results posted
- No
- Data monitoring committee
- Yes
- FDA-regulated drug
- No
- FDA-regulated device
- No
Study at a glance
From the registry record, last updated by the sponsor on 29 Oct 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- REmote iSchemic condItioning in Lymphoma PatIents REceiving ANthraCyclinEs
- ClinicalTrials.gov ID
- NCT05223413
- Acronym / sponsor ID
- RESILIENCE / RESILIENCE-H2020
- Conditions
- Anthracycline-induced Cardiac Toxicity, Lymphoma
- Study type
- Interventional
- Recruitment status
- Recruiting
- Enrolment
- 608 participants (estimated)
- Lead sponsor
- Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos IIIUniversity, hospital or other
- Collaborators
- European Commission
- Study start
- 18 Jan 2022 (actual)
- Primary completion
- Jun 2027 (estimated)
- Study completion
- Dec 2027 (estimated)
- First posted
- 4 Feb 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Multinational, prospective, proof of concept phase II, double-blinded, sham-controlled, randomized clinical trial (RCT) to evaluate the efficacy and safety of Remote Ischaemic PreConditioning (RIPC) in Lymphoma patients receiving anthracyclines.
Detailed description
Multinational, prospective, proof of concept phase II, double-blinded, sham-controlled, randomized clinical trial (RCT) to evaluate the efficacy and safety of Remote Ischaemic PreConditioning (RIPC) in lymphoma patients receiving anthracyclines. Patients scheduled to undergo ≥5 chemotherapy cycles will be eligible. Patients fulfilling all inclusion and no exclusion criteria will be enrolled and undergo baseline Cardiac Magnetic Baseline (CMR), and high sensitivity troponin (hsTn) and NT-proBNP blood test. Patients with confirmed LVEF >40% by CMR will be randomized 1:1 to RIPC vs simulated RIPC (Sham). After the third chemotherapy cycle, a second CMR+ hsTn/ NT-proBNP will be performed for the validation of the early marker of cardiotoxicity. A third hsTn/ NT-proBNP blood test will be performed in the last chemotherapy cycle. Nine weeks after finishing chemotherapy, a last CMR+ hsTn/ NT-proBNP will be performed. Patients will be followed-up for clinical events at 6, 12, 18, 30 and 42 months until the last patient undergoes the final CMR. When the last patient undergoes the third CMR, the follow-up will be closed. The median follow-up estimation for clinical endpoints is 36 months (range: 6 to 60 months).
Study design
- Primary purpose
- Prevention
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Quadruple blind (participant, care provider, investigator, outcomes assessor)
- Number of arms
- 2
- Model description
- Randomization (1:1) will be stratified by LVEF on baseline CMR (as quantified by CMR core lab /CNIC), by research Centre and by patient's gender.
| Arm | Type | Receives |
|---|---|---|
| Remote Ischemic Conditioning | Active comparator | Device: RIPCRemote Ischemic Conditioning (RIC): Patients will undergo weekly RIC during the entire span of the chemotherapy period. Each RIC session will include four cycles of 5 min blood pressure cuff inflation followed by 5 min deflation |
| simulated RIPC (Sham) | Sham comparator | Device: Simulated RIPC (Sham)Control group (Sham): Patients will undergo weekly simulated RIC (sham) during the entire span of the chemotherapy period. Each sham session will include four cycles of 5 min blood pressure cuff inflation followed by 5 min deflation. |
Who may qualify
- Ages
- 18 to 99 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (5 listed)
- ≥18 years old NHL, HL or breast cancer diagnosis Scheduled to undergo chemotherapy including ≥ 240 mg/k2 cumulative dose of anthracyclines.
- Pre-chemo LVEF >40% on screening echocardiography.
- Previous coronary revascularisation (PCI or CABG) or Medical history of previous significant nonrevascularized coronary stenosis Previous Acute Coronary Syndrome / Acute Myocardial Infarction with a LVEF > 40 LVEF 41-54% Age ≥ 65 years old Previous diagnosis of arterial hypertension (with or without treatment) Chronic kidney disease (estimated glomerular filtration rate <60ml/min/1.73m2) Current or former smoker. Obesity (BMI≥30 kg/m2) LVH on screening echocardiography (LV thickness ≥12mm). High alcohol intake (≥21 alcoholic beverages per week) Sinus rhythm on screening ECG Previous diagnosis of diabetes (except those treated with sulfonylureas or those with neuropathy) Previous non-anthracycline-based chemotherapy Signed Informed Consent Form (ICF)
Key exclusion criteria (14 listed)
- History of any of the following diseases:
- Clinical diagnosis of diabetes neuropathy
- Contraindication for CMR:
- Severe thrombocytopenia (platelets <50,000/µL) on any blood test within the previous 3 months.
- Patients participating in other clinical trials.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| RIPCThe procedure will be performed by using an electric auto-control device (modified blood pressure monitor for remote ischemic conditioning, Seagull Healthcare Aps, Denmark) for Remote Ischemic Conditioning in the arm. During the inflation period, the blood pressure cuff is inflated to 200 mmHg to stop blood flow in the arm. | Device | Remote Ischemic Conditioning |
| Simulated RIPC (Sham)The procedure will be performed by using an electric auto-control device (modified blood pressure monitor for remote ischemic conditioning, Seagull Healthcare Aps, Denmark) for Remote Ischemic Conditioning in the arm. During the inflation period, the blood pressure cuff is inflated to a low pressure not stopping blood flow in the arm. | Device | simulated RIPC (Sham) |
Primary outcome
Rate of anthracycline-induced cardiotoxicity events
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Cardiotoxicity event is defined as one of the following: * Drop in LVEF between study CMRs of ≥10 absolute points regardless the absolute value of follow- up ejection fraction (EF). * Drop in LVEF between study CMRs of ≥5 to <10 absolute points with a follow-up EF value <50% UNITS: absolute number of patients in each arm qualifying for cardiotoxicity event (i.e. each patient will be qualified at the end of the study as YES/NO).
6 secondary outcomes
Primary efficacy endpoint: (RIC vs Sham) Absolute change in LVEF
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Rate of tumor regression.
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Haematological Malignancy Patient-Reported Outcome Measure questionnaire
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Euro Quality of Life-5 dimensions questionnaire
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Change in Quality of Life-Kansas City Cardiomyopathy Questionnaire
Time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)
Rate of Heart Failure Hospitalization
Time frame: 4-60 months
Results and safety
This study is still under way. Results are not available in the source record yet.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 29 Oct 2026.
- web pageLink provided by the sponsor.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part.
Borja Ibañez, MD PhD FESC principal investigator
CNIC
24 sites in 6 countries: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing RIPC in people with Anthracycline-induced Cardiac Toxicity and Lymphoma, run by Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III at 24 sites in 6 countries.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 5 inclusion and 14 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: looking for participants now, as of the sponsor's last update on 29 Oct 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 24 sites in Spain, France, Portugal, Denmark, Germany and 1 more country. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. Some participants in this study may receive a placebo. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
This study is still under way. Results are not available in the source record yet.
How can a doctor refer a patient or contact the research team?
Contact Borja Ibañez, MD PhD FESC (914501200 ext. 4302, bibanez@cnic.es), or a site near the patient. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Rate of anthracycline-induced cardiotoxicity events (time frame: 9 weeks after the last chemotherapy cycle (anticipated to be between 150 and 200 days from enrollment)). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 29 Oct 2026.