By bringing together clinicians, patient advocates and researchers across disciplines, the UF Cardio-Oncology Symposium on April 3 provided an engaging forum to spark new research collaborations. The event showcased how innovations in precision medicine, early detection and multidisciplinary collaboration are directly enhancing patient care, ensuring the cancer patient of today does not become the cardiac patient of tomorrow.
UF researchers are at the forefront of the growing field of cardio-oncology, which involves assessing the toxicity of cancer treatment on the heart, as well as cancer’s direct effects on the heart, to improve the outcomes of patients with cancer.
The symposium, presented by the UF Health Cancer Center and the UF College of Pharmacy, built on the success of the Cancer Center’s thriving Cardio-Oncology Working Group and an inaugural symposium in 2023. This year, attendance nearly doubled, with nearly 100 researchers, clinicians and students from UF, as well as Moffitt Cancer Center and Mayo Clinic, participating.
“We’ve had a lot of cancer researchers who were not in this realm at all explore cardio-oncology and start new projects,” said Katelyn Bruno, Ph.D., FHFSA, FACC, an assistant professor in the Division of Cardiovascular Medicine who co-chaired the symposium. “Researchers are not working in silos. There are no fences here; we’re all having parties in each other’s yards. What’s ultimately going to help patients in five or 10 years is what we’re discovering in the lab.”
Moving toward precision medicine
The need for advancements in cardio-oncology is increasing. Cancer deaths in the United States have declined more than 30% over the last three decades, and there are an estimated 18 million cancer survivors in the United States today. That’s projected to increase to 26 million by 2040.
Studies have shown cardiovascular disease surpasses cancer as the cause of death for survivors of some cancers, including breast cancer and childhood cancers like leukemia, because of the effects of treatment like radiation and chemotherapy. The reverse also holds true: Patients with existing cardiovascular disease have a higher risk of developing cancer.
A precision medicine approach is needed, including using genomic markers to predict patients at risk for cardiotoxicity, said Yan Gong, Ph.D., an associate professor in the Department of Pharmacotherapy and Translational Research in the UF College of Pharmacy who co-chaired the symposium with Bruno.
She highlighted research presented by Marwa Tantawy, Ph.D., a research assistant professor in UF College of Pharmacy, using the National Institutes of Health’s All of Us database to find genetic predictors of cardiotoxicity from aromatase inhibitors in breast cancer patients.
“This research will help clinicians assess a patient’s baseline risk of cardiovascular disease before they’re treated so they can be monitored and cardioprotective strategies can be put in place,” said Gong, who is collaborating on the study with Tantawy. “We have the potential to do this for every drug that might be cardiotoxic.”
At UF, clinicians ensure each patient receives care tailored to their needs, including a personalized exercise plan, said Mustafa Ahmed, M.D., a professor of medicine and vice chief of research in the Division of Cardiovascular Medicine who presented the perspective of UF’s cardio-oncology clinic.
Other UF faculty presentations ranged from data science to improve how a heart syndrome is classified, to a heart healthy lifestyle intervention developed by UF/IFAS.
“The symposium exemplified the full spectrum of cardio-oncology,” Bruno said. “We went all the way from big data, machine learning and clinical data, down to mouse models and cells.”
‘Bedside to bench and back’
The symposium featured two keynote addresses by leading experts. Mohammed Alomar, M.D., who directs the Cardio-Oncology Program at Moffitt Cancer Center, discussed the cardiovascular toxicities of immune checkpoint inhibitors.
The second joint keynote exemplified the team-science approach to cardio-oncology. First, Mayo Clinic medical oncologist Pooja Advani, MBBS, M.D., shared the clinical perspective. Next, Nadine Norton, Ph.D., a cancer biologist at Mayo Clinic, discussed genetic discovery. Finally, DeLisa Fairweather, Ph.D., FHFSA, FAHA, a professor in the Department of Cardiology at Mayo Clinic, presented on designing cardioprotective agents based on genetic discovery.
Growing collaborations between clinical and basic scientists is essential, Bruno said.
“If we see a problem in patients, something that has room for improvement, then we can go into the lab and answer the clinical need,” she said. “It’s bedside to bench and back.”
Patient perspective
The symposium also incorporated a patient advocate session with Bruce Hill, a leukemia survivor of 20 years who’s facing heart health challenges years after treatment. Bruce’s daughter Kristie, a Community Scientist with the UF Health Cancer Center, shared her perspective as a caregiver.
“Chemo made me unable to do the things I wanted,” Bruce said, noting he grappled with anxiety, fear and a sense of loss as his active life was upended by treatment. “There were times I was scared my heart was going to give out with a stroke or heart attack.”
More attention on the connection between chemotherapy and heart complications is needed, he said, highlighting the importance of comprehensive care addressing the long-term physical and emotional challenges of cancer.
Kristie discussed the emotional strain that caregiving can have on family members. “My goal is simple: to bridge the gap between patients, caregivers, and providers because our stories matter, and they can lead to better care for everyone,” she said.
Unmet needs
The symposium also included a poster session featuring the work of undergraduates, graduate students, postdoctoral researchers and faculty, as well as Q&A sessions and opportunities to network over breakfast and lunch. Posters ranged from a study on how exercise may reduce cardiac fibrosis after chemoradiation treatment, to a biomedical engineering project to assess the effects of chemotherapeutics on cardiac tissue.
Gong and Bruno hope the symposium paves the way for UF to become a national hub for cardio-oncology research through new grants and team-based training mechanisms.
“There are a lot of unmet needs and unanswered questions, particularly around shared risk factors and shared mechanisms between cardiovascular disease and cancer,” Gong said.
