Changing Hearts and Minds: Improving Outcomes in Cancer Treatment-Related Cardiotoxicity

NCI/NHLBI 2013 Cardiotoxicity Workshop and FOA: Where are we now?
Nonniekaye Shelburne, CRNP, MS, AOCN
NCI Division of Cancer Control and Population Sciences

NIH Cardiotoxicity Task Force
Eileen Dimond, RN, MS
NCI Division of Cancer Prevention

NCORP Trials: Evolving Cardio-Oncology Study Designs
Lori Minasian, MD
NCI Division of Cancer Prevention

Heart Failure Network: Collaborations in Cancer Cardiotoxicity Patrice Desvigne-Nickens, MD
NHLBI Division of Cardiovascular Sciences

Non-clinical Toxicology: Moving Forward
Myrtle Davis-Millin, PhD
Bristol Meyers Squibb

Vascular Cardio-Oncology: Mechanisms and Implications Moving Forward
Javid Moslehi, MD
Vanderbilt University

Moving Novel Cardiotoxicity Assays into Trials
Joseph Wu, MD, PhD
Stanford University

Translating Pediatric Cardiotoxicity Research to Other Populations
Steven Lipshultz, MD
Wayne State University

Prevention Exemplar: Carvedilol in Preventing Heart Failure in Childhood Cancer Survivors
Saro Armenian, MD
City of Hope

Translation Exemplar: Energy Balance in Cardiotoxicity: Moving Mechanisms to Clinical Studies
Eugenie Kleinerman, MD
MD Anderson Cancer Center

Discussion and Audience Response
Discussants:

Javid Moslehi, MD
Vanderbilt University

Eric Chow, MD
Fred Hutchinson Cancer Center

• What are the catalysts and barriers to moving mechanisms into pre-clinical models and clinical interventions?
• What mechanistic and pre-clinical findings are ready to move into clinical studies?
• FOA: What are the most promising translational models to test the efficacy of potential cardio-protective agents and other drug combinations proposed to optimize cancer treatment and mitigate cardiovascular damage?

Key Note: Immunotherapy and Cardiotoxicity: Staying Ahead of the Curve
Javid Moslehi, MD
Vanderbilt University

Building the Evidence Base: Guideline Gaps in Risk Assessment
Saro Armenian, MD
City of Hope

Standardizing the Collection of Cardiovascular Risk Factors: ECOG-ACRIN Case Report Form
Bonnie Ky, MD
University of Pennsylvania

Pharmacogenomic Testing to Predict Cardiotoxicity and Inform Cancer Treatment Decisions
Colin Ross, PhD
BC Children’s Hospital

Predictors of Cardiovascular Disease among Breast Cancer Survivors in an Integrated Health System
Marilyn Kwan, PhD
Kaiser Permanente Northern California

Dietary Fats, Mitochondrial Function and Muscle Health: Predicting Risk
Martha Belury, PhD, RD
Ohio State University

Discussion and Audience Response
Discussant:

Joanna Brell, MD
MetroHealth Medical Center

Laleh Amiri Kordestani, MD
Food and Drug Administration

• What are the catalysts and barriers to integrating risk tools into clinical practice?
• What clinical risk findings are ready to move into validation studies and/or guidelines?
• FOA: What are the best translational models to test the efficacy of potential cardio-protective agents and other drug combinations proposed to optimize cancer treatment and mitigate cardiovascular damage?

Building the Evidence Base: Guideline Gaps in Detection
Saro Armenian, MD
City of Hope

Standardizing Biomarker and Imaging Across Studies: ECHO Exemplar
Bonnie Ky, MD
University of Pennsylvania

Cardiac Assay Utilization Post Cancer Treatment: BEAT HF
Joerg Hermann, MD
Mayo Clinic

Surveillance: Who, When and How?
Chau Dang, MD
Memorial Sloan Kettering Cancer Center

Discussion and Audience Response
Discussant:

Anthony Yu, MD
Memorial Sloan Kettering Cancer Center

• What are the catalysts and barriers to integrating detection/screening techniques into clinical practice?
• What detection/screening findings are ready to move into validation studies and/or guidelines?
• FOA: How can we utilize known and novel genetic markers, pharmacogenomic measures, biomarkers, imaging tools and other measures, including combinations of measures, to identify sub-clinical derangements, define cardio-oncology risk, monitor cardiovascular function and guide effective and safe management strategies?
• FOA: How does early detection and management of cardiotoxicity impact cardiac and cancer short- and long-term outcomes?

Welcome
Bishow Adhikari, PhD
NHLBI, Division of Cardiovascular Sciences

Key Note: The Intersection of Spaceflight and Cancer Cardiotoxicity: Exercise Training-Induced Cardioprotection
Jessica Scott, PhD
Memorial Sloan Kettering Cancer Center

Building the Evidence Base: Guideline Gaps in Prevention and Management
Saro Armenian, MD
City of Hope

Photon versus Proton Radiation and Cardiac Outcomes
Justin Bekelman, MD
University of Pennsylvania

Dual Action RSK Inhibitor: Targeting Metastasis and Providing Cardioprotection
Deborah Lannigan, PhD
Vanderbilt University Medical Center

Dexrazoxane and Prevention of Anthracycline-Related Cardiomyopathy
Eric Chow, MD
Fred Hutchinson Cancer Center

WISER Survivorship: Management of Weight and Exercise
Kathryn Schmitz, PhD, MPH
University of Pennsylvania

Exercise Interventions in Cancer Survivors
Chunkit Fung, MD
University of Rochester

Integrating Cardio-oncology into Cancer Survivorship Care
Jennifer Klemp, PhD
University of Kansas

Discussion and Audience Response
Discussant:

Greg Hundley, MD
Wake Forest Baptist Health

• What are the catalysts and barriers to integrating detection/screening techniques into clinical practice?
• What detection/screening findings are ready to move into validation studies and/or guidelines?
• FOA: How can we utilize therapeutic and behavioral interventions that do not interfere with anti-cancer therapy efficacy but can mitigate or reverse cardiovascular damage?
• FOA: What are the optimal pharmacologic and non-pharmacologic approaches to prevent cancer treatment-related cardiotoxicity during cancer treatment and survivorship care, and what risk assessment strategies can best identify higher risk patient subgroups that are most likely to receive the greatest benefit from these approaches?

Setting Priorities - A 10-Year Plan (Open Discussion)

• Leveraging existing resources
• Establishing new resources
• Knowledge Gaps
• What have we learned from cardiotoxicity research in breast cancer and pediatrics that is ready for validation in other understudied populations (disease, treatment, age, race)?
• How to overcome barriers to studying cardiac outcomes among understudying cancer populations and new cancer treatments?