Can flaxseed “milk” prevent anthracycline mediated cardiotoxicity in women with breast cancer (CANFLAX-BC)?

Cardio-Oncology focuses on the prevention, diagnosis, and management of individuals with cancer who are at risk of developing cardiovascular complications as a result of their anti-cancer treatment. The aim of the “Can flaxseed “milk” prevent chemotherapy mediated cardiotoxicity in women with breast cancer (CANFLAX-BC) study” was to investigate whether consumption of flaxseed (FLX) “milk” can prevent cardiac dysfunction in women with breast cancer treated with anthracyclines. In this small pilot double-blinded, single centre, prospective randomized controlled clinical trial, women with breast cancer were randomized to oral consumption of either placebo oat fiber “milk” or FLX “milk” for a total of 4 months while receiving anthracycline-based chemotherapy. Serial echocardiography and cardiac biomarkers were measured at baseline, 4-months, and 6-months follow-up. Between 2021 and 2023, a total of 21 women with early-stage breast cancer (mean age 48 ± 10 years, BMI 28 ± 5 kg/m2), treated with an anthracycline based chemotherapy regimen, were enrolled in the CANFLAX-BC study. During the 4-month intake period, a total of 8 women received oat fibre “milk” and 13 women received FLX “milk” while receiving anthracyclines, with a comparable adherence rate of 70% for both groups. At baseline, 4-months, and 6-months follow-up, the LVEF was 68±4%, 69±3%, and 66±4%, respectively, for the oat fibre “milk” group and 67±5%, 68±4%, and 66±5%, respectively, for the FLX “milk” group (p = NS). Although the mean global longitudinal strain (GLS) was comparable between both groups at baseline, the GLS was lower at -13.8 ± 0.3% (4 months) and − 15.1 ± 0.3% (6 months) for the oat fibre “milk” group as compared to a GLS of -18.4 ± 0.3% (4 months) and − 18.5 ± 0.2% (6 months) for the FLX “milk group (p < 0.05). In women receiving an anthracycline based chemotherapy regimen for breast cancer, this small pilot study suggests that FLX “milk” consumption may prevent early cardiotoxicity as reflected by preservation of GLS parameters.