Carvedilol in Reducing the Risk of Cardiotoxicity in Patients with Stage I-III Breast Cancer Treated with Doxorubicin and/or Trastuzumab

Inclusion Criteria

• Diagnosed with stage I-III breast cancer, with treatment plan to include therapy with anthracyclines and/or trastuzumab in the adjuvant or neoadjuvant setting
• Able to swallow tablets
• Study team is able to obtain all necessary information for calculating baseline CTX risk (including echocardiographic images for quantitation of left ventricular ejection fraction [LVEF]) prior to enrollment
• Standard of care pre-chemotherapy measurement of LVEF by echocardiogram (patients with pre-chemo multigated acquisition scan [MUGA] will be asked to come in for a research echocardiogram as part of screening)

Exclusion Criteria

• Pregnant or breast feeding. Due to unknown risks and potential harm to the unborn fetus a negative pregnancy test within 10 days prior to enrollment is required in women with child-bearing potential. Due to the potential nursing infant harm, women who are currently breast feeding are not eligible for this study
• Contraindication to carvedilol * Baseline systolic blood pressure < 90 mmHg (if multiple blood pressures are available in the medical record within 1 month prior to screening, the average systolic blood pressure [SBP] will be considered) * Baseline heart rate < 55 beats per minute (bpm) consistent with severe bradycardia (if multiple resting heart rates are available in the medical record within 1 month prior to screening, the average heart rate will be considered) * Allergy to carvedilol * History of bronchial asthma or related bronchospastic conditions * Known history of sick sinus syndrome * Severe hepatic impairment, defined as serum bilirubin > 3.0 x upper limit of normal (ULN), aspartate aminotransferase (AST) or alanine aminotransferase (ALT) > 5.0 ULN within 28 days of enrollment * Second- or third-degree atrioventricular (AV) block, as determined by electrocardiogram * Severe bradycardia (unless permanent pacemaker is in place) * Patients in cardiogenic shock or decompensated heart failure requiring the use of intravenous (IV) inotropic therapy * Current use of ** Bupropion (Wellbutrin) ** Fluoxetine (Prozac) ** Paroxetine (Paxil) ** Quinidine (Quinidex) ** Duloxetine (Cymbalta) ** Digoxin
• Current treatment with beta blocker
• Unable to provide consent