Cancer Treatment-Related Cardiotoxicity: Understanding the Current State of Knowledge and Developing Future Research Priorities

March 20-21, 2013


The goals of anti-cancer therapies are to prevent recurrence, prolong life, and provide cure. Partly due to improvements in treatment, the population of cancer survivors is large and growing. However, cancer treatment-related cardiotoxicity is the leading cause of treatment-associated mortality in survivors of pediatric and adolescent cancers, after recurrence and second or subsequent malignancies. It is one of the most common post-treatment issues among five- to ten-year survivors of adult cancer. In addition, cancer patients may receive suboptimal therapy due to concern about potential cardiotoxicity, resulting in increased disease progression and mortality. The scientific knowledge gaps on cancer treatment-related cardiotoxicity are numerous, spanning basic and clinical science, and influence the advancement of science in this area. A joint effort of multiple disciplines within cardiology and oncology is required, thus this meeting includes leadership from the National Heart, Lung, and Blood Institute's (NHLBI) Division of Cardiovascular Sciences (DCVS) along with the National Cancer Institute's Divisions of Cancer Control and Population Sciences (DCCPS) and Cancer Prevention (DCP).

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This meeting brought together multiple disciplines within cardiology and oncology to identify research priorities aimed at improving the cardiac outcomes of cancer survivors. Research in cancer treatment-related cardiotoxicities is dependent on research in all other aspects of cardiotoxicity, as well as the development of new therapies, screening, and treatments that will impact the epidemiology and genomics of cardiotoxicity. The goal of this meeting was to identify research priorities in the area of cancer treatment-related cardiotoxicity to inform program announcements, other funding initiatives, and opportunities, and review articles describing current gaps and priorities for this important research area.

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View agenda for Wednesday, March 20
Wednesday, March 20 Topic
8:00 a.m. - 8:30 a.m. Registration
Workshop Introductions and Overview
Moderator: Joanna Brell, M.D., Division of Cancer Prevention (DCP), NCI
8:30 a.m. - 8:55 a.m. Welcome and Introductions

Robert T. Croyle, Ph.D.
Division of Cancer Control and Population Sciences (DCCPS), NCI

Lori Minasian, M.D.

Michael Lauer, M.D.
Director of Cardiovascular Sciences (DCVS), NHLBI

8:55 a.m. - 9:10 a.m. Workshop Overview and Objectives

Nonniekaye Shelburne, C.R.N.P., M.S., A.O.C.N.
Epidemiology and Genomics Research Program (EGRP), DCCPS, NCI

9:10 a.m. - 9:25 a.m. Cancer Treatment-Related Cardiotoxicity: How Big is the Problem?

Andrew Freedman, Ph.D.

9:25 a.m. - 9:40 a.m. Basic Science of Cancer Treatment-Related Cardiotoxicity

Thomas Force, M.D.
Temple University

Session 1: The Biology and Mechanisms of Cancer Treatment-Related Cardiotoxicity
Moderator: Bishow Adhikari, Ph.D., DCVS, NHLBI
9:40 a.m. - 10:00 a.m. Mechanisms of Cancer Treatment-Related Cardiotoxicity: Similarities/Connections with Cardiovascular Disease

Speaker: Aarif Khakoo, M.D.
Stanford University School of Medicine, Amgen

10:00 a.m. - 10:15 a.m. Contemporary Agents in Cancer Treatment-Related Cardiotoxicity

Speaker: Edward Yeh, M.D.
The University of Texas MD Anderson Cancer Center

10:15 a.m. - 10:30 a.m. Combination Cancer Therapy: The Cardiac Impact of Adding New Agents to Old Regimens

Speaker: Bonnie Ky, M.D., M.S.C.E.
Abramson Cancer Center of the University of Pennsylvania

10:30 a.m. - 10:45 a.m. BREAK
10:45 a.m. - 11:00 a.m. Implications of Making a New Compound with Cardiotoxicity Potential: When Is the Toxicity Too Much?

Speaker: Colin Dollery, F.R.C.P.

11:00 a.m. - 11:30 a.m. Q&A / Open Discussion
11:30 a.m. - 12:00 p.m. Session 1 Priority Setting
12:00 p.m. - 1:00 p.m. LUNCH
Session 2: Preclinical Drug Development and Screening
Moderator: Myrtle Davis Millin, D.V.M., Ph.D., Division of Cancer Treatment Diagnosis (DCTD), NCI
1:00 p.m. - 1:15 p.m. Models for Drug Development and Screening

Speaker: Kyle Kolaja, Ph.D.
Cellular Dynamics International

1:15 p.m. - 1:30 p.m. What Animal Models Are Available to Inform Early Phase Therapeutics?

Speaker: Thomas Force, M.D.
Temple University

1:30 p.m. - 1:45 p.m. The Role of Systems Biology in Cardiotoxicity Research

Speaker: Darrell Abernethy, M.D., Ph.D.
National Institute on Aging

1:45 p.m. - 2:00 p.m. Drug Redesign: Animal Models

Speaker: G.C. Teg Pipes, Ph.D.

2:00 p.m. - 2:30 p.m. Q&A / Open Discussion
2:30 p.m. - 3:00 p.m. Session 2 Priority Setting
3:00 p.m. - 3:15 p.m. BREAK
Session 3: Early Phase Therapeutics
Moderator: Scot Remick, M.D., West Virginia University Health Sciences Center
3:15 p.m. - 3:30 p.m. Approach to Standardization of Safety/Screening Measurements and Toxicity Grading in Early Phase Clinical Trials

Speaker: Daniel Lenihan, M.D.
Vanderbilt University

3:30 p.m. - 3:45 p.m. Applying metabolomics to cancer treatment related cardiotoxicity

Speaker: Robert Gerzten, M.D.
Massachusetts General Hospital

3:45 p.m. - 4:00 p.m. Cardiovascular complications associated with novel angiogenesis inhibitors: emerging evidence and evolving perspectives

Speaker: Javid Moslehi, M.D.
Dana-Farber Cancer Institute, Brigham and Women's Hospital, Harvard Medical School

4:00 p.m. - 4:15 p.m. Bridging/Applying Mechanism of Cancer Treatment-Related Cardiotoxicity to Screening and Risk Prediction

Speaker: Marielle Scherrer-Crosbie, M.D., Ph.D.
Massachusetts General Hospital

4:15 p.m. - 4:35 p.m. Q&A / Open Discussion
4:35 p.m. - 5:00 p.m. Session 3 Priority Setting

View agenda for Thursday, March 21
Thursday, March 21 Topic
8:00 a.m. - 8:30 a.m. Registration
8:30 a.m. - 8:45 a.m. Clinical Care of Cancer Treatment-Related Cardiotoxicity

Speaker: Kevin Oeffinger, M.D.
Memorial Sloan-Kettering Cancer Center

Session 4: Cancer Treatment-Related Cardiotoxicity: Risk, Screening, & Detection
Moderator: Ming Hui Chen, M.D., Brigham and Women's Hospital, Harvard Medical School
8:45 a.m. - 9:00 a.m. Epidemiology of Hypertension and Heart Muscle Toxicity in Cancer Care

Speaker: Michael Maitland, M.D., Ph.D.
University of Chicago Medicine

9:00 a.m. - 9:15 a.m. Pre-Treatment Risk Assessment of Cardiotoxicity: Pharmacogenomics

Speaker: Smita Bhatia, M.D., M.P.H.
City of Hope

9:15 a.m. - 9:30 a.m. Clinical Biomarkers in Primary Heart Failure: Detecting Asymptomatic Toxicity

Speaker: G. Michael Felker, M.D., M.H.S.
Duke University School of Medicine

9:30 a.m. - 9:45 a.m. Clinical Biomarkers in Cancer Treatment-Related Cardiotoxicity: Detecting Asymptomatic Toxicity

Speaker: Jean-Bernard Durand, M.D.
University of Texas MD Anderson Cancer Center

9:45 a.m. - 10:00 a.m. BREAK
10:00 a.m. - 10:15 a.m. Clinical Imaging: Detecting Asymptomatic Toxicity

Speaker: Juan Carlos Plana, M.D.
Cleveland Clinic

10:15 a.m. - 10:30 a.m. The Patient's Perspective

Speaker: Neeraj Arora, Ph.D.
Applied Research Program (ARP), DCCPS, NCI

10:30 a.m. - 11:00 a.m. Q&A / Open Discussion
11:00 a.m. - 11:30 a.m. Session 4 Priority Setting
11:30 a.m. - 12:30 p.m. LUNCH
Session 5: Cancer Treatment-Related Cardiotoxicity: Prevention & Treatment
Moderator: Alice Mascette, M.D., DCVS, NHLBI
12:30 p.m. - 12:45 p.m. Pharmacologic Methods for Prevention and Treatment of Hypertension

Speaker: Philip Sager, M.D.
Sager Consulting Partners

12:45 p.m. - 1:00 p.m. Pharmacologic Methods for Prevention & Treatment of Heart Muscle Toxicity

Speaker: Roberta Gottlieb, M.D.
San Diego State University

1:00 p.m. - 1:15 p.m. Pharmacologic Methods for Prevention of Cardiotoxicity in Breast Cancer

Speaker: Maya Guglin, M.D., Ph.D.
University of South Florida

1:15 p.m. - 1:30 p.m. Cardiovascular Exercise and Biomarkers in Cancer Survivors

Speaker: Jennifer Klemp, Ph.D., M.P.H.
University of Kansas Medical Center

1:30 p.m. - 1:45 p.m. Nutrition in the Prevention and Treatment of Cancer Treatment-Related Cardiotoxicity

Speaker: Wendy Demark-Wahnefried, Ph.D., R.D.
University of Alabama

1:45 p.m. - 2:15 p.m. Q&A / Open Discussion
2:15 p.m. - 2:45 p.m. Session 5 Priority Setting
2:45 p.m. - 3:00 p.m. BREAK
Session 6: Establishing Cohorts and Translating Findings
Moderator: Richard Steingart, M.D., Memorial Sloan-Kettering Cancer Center
3:00 p.m. - 3:15 p.m. Barriers in the Development of Cancer Treatment-Related Cardiotoxicity Guidelines

Speaker: JoAnn Lindenfeld, M.D.
University of Colorado Hospital

3:15 p.m. - 3:30 p.m. Establishing Cardiotoxicity Cohorts: Learning from the CCSS

Speaker: Gregory Armstrong, M.D., M.S.C.E.
St. Jude Children's Research Hospital

3:30 p.m. - 3:45 p.m. NCI Cardiovascular Toxicities Panel Recommendations

Speaker: Scot Remick, M.D.
West Virginia University Health Sciences Center

3:45 p.m. - 4:00 p.m. Q&A / Open Discussion
4:00 p.m. - 4:15 p.m. Session 6 Priority Setting
4:15 p.m. - 5:00 p.m. Review and Vote on Research Priorities

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Video Archive

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Workshop Summary

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Workshop Planning Committee:

For further information or questions, contact Nonniekaye F. Shelburne, C.R.N.P., M.S., A.O.C.N. Program Director, Clinical and Translational Epidemiology Branch.

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