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The International CardiOncology Society An Update for 2014. Daniel J Lenihan , MD Professor, Division of Cardiovascular Medicine Director, Clinical Research Vanderbilt University. The International CardiOncology Society An Update. Exactly what does this society mean?
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The International CardiOncology Society An Update for 2014 Daniel J Lenihan, MD Professor, Division of Cardiovascular Medicine Director, Clinical Research Vanderbilt University
The International CardiOncology SocietyAn Update • Exactly what does this society mean? • How do we do things? • What are our goals? • How do we achieve them? • Is there really a future for this?
ICOS is: • A collection of interested providers focused on improving cardiac health in cancer patients • A mix of academic, practice, governmental, regulatory, and industry professionals • Committed to our patients wherever they are
The International CardiOncology SocietyAn Update • Exactly what does this society mean? • How do we do things? • What are our goals? • How do we achieve them? • Is there really a future for this?
We do things in many ways: • Day to day improvement in our practices • Monthly webinars available to all • Periodic presentations at major meetings • Annual ICOS congresses • Development of current “Best Practice” • Data review for ongoing early phase and late phase clinical trials • Ongoing participation in major professional society efforts • Ongoing individual and multicenter research • Consistent involvement with regulatory agencies in many countries
The International CardiOncology SocietyAn Update • Exactly what does this society mean? • How do we do things? • What are our goals? • How do we achieve them? • Is there really a future for this?
ICOS goals • Research • Engage large databases • Cardiac safety endpoint adjudication • Hypothesis testing research • Advocacy • Patients/families • Providers • Education • Provider case review • Patient directed • Professional meetings • Industry/regulatory webinars • Trainee organization • Be a Resource • Up to Date information • Identify Goals for the future • Provide innovation • Be an example of collaboration
The International CardiOncology SocietyAn Update • Exactly what does this society mean? • How do we do things? • What are our goals? • How do we achieve them? • Is there really a future for this?
PREDICT Study: A multicenter study in Patients undergoing anthRacycline-based chemotherapy to assess the Effectiveness of using biomarkers to Detect and Identify Cardiotoxicity and describe Treatment Daniel J Lenihan, MD Professor, Division of Cardiovascular Medicine Vanderbilt University CCOP Annual Meeting 2010
Total Accrual: 597 patients
In the case of HER2+ breast cancer, treatment clearly benefitted the disease but came at a cost Slamon D et al; NEJM 2011:365:1273-83
The effect of time for initiation of HF therapy and the percent of patients who improve 100 64% 80 60 Responders (%) 28% 40 7% 20 0% 0% 0% 0% 0 1-2 2-4 8-10 4-6 6-8 >12 10-12 months (n=35) (n=75) (n=20) (n=12) (n=8) (n=44) (n=7) D Cardinale, et al. JACC 2010, jan 26.
In regards to Ischemic insults, we have a paradigm Kloner et al, Circ 2001; p2981
Statin therapy prior to and during chemotherapy was protective JACC 2012, p 2384
Prevention of Cardiotoxicity is possible Bosch, X et al, JACC 2013, p 2355
Are there things on the cancer therapy horizon that could be concerning for cardiomyopathy?
There is a balance between protein synthesis and degradation Monte S. Willis, M.D., Ph.D., and Cam Patterson, M.D., M.B.A. NEJM 2013;368:455-64.
Dick,LR and Flemming,PE Drug Discovery Today ;15 (5/6) March 2010
The International CardiOncology SocietyAn Update • Exactly what does this society mean? • How do we do things? • What are our goals? • How do we achieve them? • Is there really a future for this?
A Paradigm for Cardiology Oncology Cooperation Kouri M et al. Circulation 2012
ICOS= A public, private, patient, provider, regulatory, governmental PARTNERSHIP