Randomized Study in Oncology Patients with Advanced Heart Failure and the “Protective Effect of Cancer” in These Patients

Randomized Study in Oncology Patients with Advanced Heart Failure and the “Protective Effect of Cancer” in These Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Randomized Study in Oncology Patients with Advanced Heart Failure and the “Protective Effect of Cancer” in These Patients Camilo Fernández Bravo This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6641211/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The coexistence of advanced heart failure (HF) and cancer presents a complex clinical scenario. Recent observational data suggest a potential protective effect of cancer on HF outcomes, possibly mediated by tumor-related metabolic or inflammatory pathways. This study investigates whether cancer confers a survival benefit in patients with advanced HF through a randomized controlled trial (RCT). Methods: We conducted a multicenter RCT involving 1,200 patients with stage D HF, of whom 600 had a concurrent cancer diagnosis (various types) and 600 did not. Patients were randomized to standard HF care or an observational arm monitoring cancer-related biomarkers. The primary endpoint was all-cause mortality at 24 months. Secondary endpoints included hospitalization rates, quality of life (QoL), and cardiac function. Results: At 24 months, the cancer group exhibited a significantly lower mortality rate (28.5% vs. 39.2%, hazard ratio [HR] 0.68, 95% CI 0.55–0.84, p<0.001) compared to the non-cancer group. Hospitalization rates were reduced in the cancer group (p=0.02), and QoL scores improved (p=0.04). Biomarker analysis revealed elevated levels of anti-inflammatory cytokines (IL-10) in the cancer group, correlating with improved left ventricular ejection fraction (LVEF). Conclusion: Cancer may exert a protective effect in advanced HF, potentially through immunomodulatory mechanisms. These findings warrant further investigation into cancer-related pathways as therapeutic targets in HF. Cardiac & Cardiovascular Systems Heart Failure Cancer Cardio-Oncology Randomized Controlled Trial Protective Effect Biomarkers Full Text Additional Declarations The authors declare no competing interests. Supplementary Files SupplementaryRawandComplementaryData.pdf OncoCardioDatasetDataDictionaryandSummary.pdf OncoCardioRandomizedStudyDataset1200.csv.pdf Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6641211","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":454952222,"identity":"add1d263-33b6-49ba-b2d1-392fd507f099","order_by":0,"name":"Camilo Fernández 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Recent observational data suggest a potential protective effect of cancer on HF outcomes, possibly mediated by tumor-related metabolic or inflammatory pathways. This study investigates whether cancer confers a survival benefit in patients with advanced HF through a randomized controlled trial (RCT).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e We conducted a multicenter RCT involving 1,200 patients with stage D HF, of whom 600 had a concurrent cancer diagnosis (various types) and 600 did not. Patients were randomized to standard HF care or an observational arm monitoring cancer-related biomarkers. The primary endpoint was all-cause mortality at 24 months. Secondary endpoints included hospitalization rates, quality of life (QoL), and cardiac function.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e At 24 months, the cancer group exhibited a significantly lower mortality rate (28.5% vs. 39.2%, hazard ratio [HR] 0.68, 95% CI 0.55–0.84, p\u0026lt;0.001) compared to the non-cancer group. Hospitalization rates were reduced in the cancer group (p=0.02), and QoL scores improved (p=0.04). Biomarker analysis revealed elevated levels of anti-inflammatory cytokines (IL-10) in the cancer group, correlating with improved left ventricular ejection fraction (LVEF).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e Cancer may exert a protective effect in advanced HF, potentially through immunomodulatory mechanisms. These findings warrant further investigation into cancer-related pathways as therapeutic targets in HF.\u003c/p\u003e","manuscriptTitle":"Randomized Study in Oncology Patients with Advanced Heart Failure and the “Protective Effect of Cancer” in These Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-11-06 06:28:15","doi":"10.21203/rs.3.rs-6641211/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"d544c258-aa52-4ad4-a93a-c346ff323be5","owner":[],"postedDate":"November 6th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":48365063,"name":"Cardiac \u0026 Cardiovascular Systems"}],"tags":[],"updatedAt":"2025-11-06T06:28:15+00:00","versionOfRecord":[],"versionCreatedAt":"2025-11-06 06:28:15","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6641211","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6641211","identity":"rs-6641211","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}