Poster Presentation 35th Lorne Cancer Conference 2023

Australian cardio-oncology registry a prospective observational study of patients who have been exposed to cardio-toxic chemotherapy (#127)

Lane Collier 1 , Rachel Conyers 1 2 , Claudia Toro 1 2 , Ben Felmingham 1 , Mangesh Jadhav 3 4 , André La Gerche 5 , David Celermajer 6 7 8 , Lisa Horvath 9 , John O'Sullivan 6 7 8 , David Elliott 1 , Julian Ayer 10 , Joy Fulbright 11 , Nicole Kennedy 12 , Marion Mateos 7 13 , Jocelyn Finney 9
  1. Heart Regenration, Murdoch Children's Research Institute , Parkville, VIC, Australia
  2. Children's Cancer Centre, The Royal Children's Hospital , Parkville, VIC, Australia
  3. The Royal Children's Hospital, Parkville, VIC, Australia
  4. Monash Heart, Clayton, VIC, Australia
  5. Baker Heart and Diabetes Institute , Melbourne , VIC, Australia
  6. Heart Research Institute, Newtown, NSW, Australia
  7. Sydney University, Camperdown, NSW, Australia
  8. Royal Prince Alfred Hospital, Melbourne, VIC, Australia
  9. Chris O'Brien Lifehouse, Sydney, NSW, Australia
  10. Sydney Children's Hospital Westmead, Westmead, NSW, Australia
  11. Children's Oncology Group Cardiovascular Task Force, Children's Mercy Hospital, Kansas City, MO, USA
  12. The Royal Children's Hospital, Brisbane, QLD, Australia
  13. Sydney Children's Hospital, Randwick, NSW, Australia

Background

With remarkable advances in cancer therapy, long term health outcomes are more than ever an essential treatment focus. The multidisciplinary area of cardio-oncology has emerged to address cardiac complications arising pre-emptively and proactively from cancer therapies. The Australian cardio-oncology registry and biobank (ACOR) provides a platform of longitudinal data which can be developed to better provide for patients at risk of developing cardiotoxic complications.

 

Objective

To create and maintain a cardio-oncology registry and biobank that facilitates more reliable estimates of the incidence of cardiotoxicity; and provides a research opportunity to investigate predisposition using genome sequencing and patient-derived pluripotent stem cell models.

 

Method

Prospective longitudinal study consisting of 4 study arms (Registry, Biobanking, MBS and PBS and Extended Cardiac Evaluation) across paediatric and adults patients within Australia. All patients provide a biobank sample for DNA extraction and genome sequencing, together with a cryopreserved sample suitable for iPSC development. Patients are screened across a range of demographic, and oncology and cardiology endpoints.

 

Eligibility: A cancer diagnosis and exposure to cardiotoxic therapeutics inclusive of chemotherapy, radiotherapy, molecular inhibitors and immunotherapy.

 

Results

ACOR was established in 2018 and has expanded across 12 study sites with a total of 172 participants. Initially focused on paediatric patients, this study has now expanded to adults and has seen a growth of 58 participants within the last 6 months. 83 patients have provided samples suitable for genome sequencing and iPSC development. Approach to cardiac surveillance and workup is protocolized and based on recently developed cardio-oncology guidelines in paediatric patients, together with previously published adult cardio-oncology guidelines. In addition, a cardio-oncology clinic was introduced for high-risk patients to facilitate communication across disciplines to improve clinical outcomes. 

 

Conclusion

This study has been limited by the pandemic however, recent growth has provided invaluable insights into the population of patients at high risk of cardiotoxic complications from cancer treatment. A uniform approach to assessment and surveillance will aid risk stratification for this cohort. Furthermore, genome sequencing on all patients together with the ability to make functional cardiomyocyte models provides an opportunity to inform heritability and susceptibility to therapy related cardiotoxic complications.