Penn researchers present findings on cardiac risks for cancer patients

November 10, 2020

PHILADELPHIA - Developments in cancer treatment and care have dramatically improved survival for cancer patients, however, these treatments can also damage other parts of the body, including the heart. At the American Heart Association's Scientific Sessions 2020, physician-researchers from the Perelman School of Medicine at the University of Pennsylvania will present findings about cardiac care for cancer patients and survivors.

Cardiovascular Toxicities of Cyclin Dependent Kinase 4/6 Inhibitors in Metastatic Breast Cancer Patients

While the field is aware of the potential damage cancer treatment can have on the heart, little data exists regarding the connection between cardiovascular adverse events--such as heart failures and arrhythmias--and Cyclin Dependent Kinase (CDK) 4/6 inhibitor therapy agents. CDK 4/6 inhibitors, such as palbociclib, ribociclib, and abemaciclib, are a novel class of cancer therapeutics which have significantly improved survival in patients with hormone receptor positive (ER/PR+), HER2 negative metastatic breast cancer.

An analysis of the OneFlorida dataset led by Michael Fradley, MD, medical director of Penn Cardio-Oncology and an associate professor of Cardiovascular Medicine, found that cardiovascular adverse events occurred in 16.8 percent of adult patients without prior cardiovascular disease who received at least one CDK 4/6 inhibitor. Of those patients, 17.2 percent died.

"While no single CDK 4/6 inhibitor is uniquely responsible for these findings, cardiovascular adverse events are common in these patients. Patients taking CDK 4/6 inhibitors should be monitored with aggressive risk mitigation strategies to minimize any potential issues," Fradley said.

Fradley will present the findings in a moderated digital poster session on November 13, 2020 at 10:00 a.m. EST/9:00 a.m. CST. It will be available through the meeting's OnDemand content until the end of the conference on November 17, 2020, 9:30 p.m. EST/8:30 p.m. CST.

Additional authors include Penn's Bonnie Ky, as well as Nam Nguyen, Yiqing Chen, Avirup Guha, Jenica N. Upshaw, and Yan Gong.

Structural Characterization of Cardiotoxicity of Induced by Chemotherapy Agents

Marielle Scherrer-Crosbie, MD, PhD, director of the Cardiac Ultrasound Laboratory and a professor of Cardiovascular Medicine, will review the recent advances on how cardiac imaging can provide insights into the mechanisms of chemotherapy induced cardiotoxicity and identify patients at risk.

Scherrer-Crosbie's interest is the relationships between cardiovascular health and hematological malignancies--cancers that affect the blood, bone marrow, and lymph nodes, such as the various types of leukemia. Research from her group show a high rate of adverse cardiovascular events, especially heart failure, in patients with acute leukemia. To identify a patient's risk for heart failure following chemotherapy treatment, Scherrer-Crosbie developed a risk score based on clinical and imaging variables.

"Our goal is to help clinicians identify patients with the highest risk for potential cardiac damage, so they can more closely tailor treatment plans and monitor patients in order to improve outcomes," Scherrer-Crosbie said.

The session will take place during the ATVB journal session on the cardiovascular effects of anticancer treatments/agents. The session is part of the meeting's OnDemand content, and will be available from the start of the conference November 13, 2020 at 10:00 a.m. EST/9:00 a.m. CST until the end of the conference November 17, 2020, 9:30 p.m. EST/8:30 p.m. CST.

Novel Practical Concepts in Cardio-Oncology

During the AHA sessions, Bonnie Ky, MD, MSCE, the Founders Associate Professor of Cardiovascular Medicine, Epidemiology, and Cardio-Oncology; director of the Penn Cardio-Oncology Translational Center of Excellence, and editor-in-chief of JACC: CardioOncology, will address advances in the field of cardio-oncology, and new approaches to improving the cardiovascular care of cancer patients through personalized medicine.

"We know that potentially life-saving cancer therapies can impact the heart, but we believe these potential adverse reactions are detectable, treatable, and preventable," Ky said. "To me, it's a travesty that a patient can survive cancer, but then suffer from cardiovascular disease. We are working to try to understand in whom, why, and when do these adverse cardiovascular events occur in patients, so we can ultimately improve the lives of our cancer patients."

By using novel tools such as blood tests, imaging tools such as 2D and 3D echocardiography, and a person's genetic makeup, it may be possible to identify who is at increased risk prior to declines in cardiac function occurring. There are also newer strategies, including cardioprotection-guided risk stratification and efforts to identify, prevent, and treat heart disease in cancer patients.

Ky's session, titled "Personalized Medicine and Permissive Cardiotoxicity," takes place on Saturday, November 14, 2020 at 8:40 p.m. EST/7:40 p.m. CST.
Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $8.6 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $494 million awarded in the 2019 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: the Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center--which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report--Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; and Pennsylvania Hospital, the nation's first hospital, founded in 1751. Additional facilities and enterprises include Good Shepherd Penn Partners, Penn Medicine at Home, Lancaster Behavioral Health Hospital, and Princeton House Behavioral Health, among others.

Penn Medicine is powered by a talented and dedicated workforce of more than 43,900 people. The organization also has alliances with top community health systems across both Southeastern Pennsylvania and Southern New Jersey, creating more options for patients no matter where they live.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2019, Penn Medicine provided more than $583 million to benefit our community.

University of Pennsylvania School of Medicine

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