5. Study Limitations
cancer, cardiotoxicity
CANCER, BREAST CANCER
The main limitations of the trial were that it was a single-centre trial with a small number of patients. This study can be interpreted as a pilot study, and with a new sample size calculation based on the data collected, further research is warranted. Also, the study only included women with the highest prevalence of breast cancer. Therefore, the results cannot be generalized to larger populations. We planned to have patients of all genders with different types of cancer who were due to receive anthracycline treatment, but we could only include women with breast cancer. We think that the main reason is that most patients treated with anthracyclines are women with breast cancer.Another limitation was that only patients with a low risk of cardiotoxicity could be included. However, enrolling patients at high risk of cardiotoxicity in cardioprotective trials is challenging because most are already being treated with ACEIs/ARBs and BBs, which are known to have beneficial cardioprotective effects. As the follow-up results may have been influenced by the cardioprotective treatment with ACEIs in CTRCD, we consider it unethical to withhold treatment in this case.