New Research Supports Upcoming Meeting on Cardiac Late Effects
Adult survivors of childhood cancer are at an elevated risk of cardiovascular disease (CVD) compared to the general population and too often are underdiagnosed and undertreated, according to new research published in the Journal of the American Heart Association (JAHA).
Researchers studied nearly 600 adult survivors of childhood cancer and compared their heart health to a peer group with no cancer history. Among the notable takeaways:
18 percent of the survivors studied had hypertension (high blood pressure), compared to 11 percent of the control group.
The cancer survivor group was 80 percent more likely to be undertreated for several cardiovascular risk factors, including hypertension, diabetes, and high cholesterol.
Among the cancer survivors, men were twice as likely to be underdiagnosed and undertreated for cardiovascular risk factors. Overweight or obese survivors were 2-3 times more likely to be underdiagnosed and undertreated.
Another recent study focused on heart health in survivors comes from researchers at St. Jude who have identified a genetic variant that predisposes childhood cancer survivors to heart problems as adults if they are treated with the chemotherapy agent doxorubicin. This study, published in the Journal of the National Cancer Institute, sought to better understand why some survivors develop cardiac problems later in life while some do not, even when receiving the same treatment for the same cancer. For the first time, scientists identified a variant near the KCNK17 gene that can put survivors exposed to doxorubicin at a significantly elevated risk of cardiac complications later in life.
These studies add to a growing body of evidence around cardiac risks for childhood cancer survivors. Previous research has found that childhood cancer survivors have a sevenfold greater risk for dying of cardiac disease compared to the general population (Journal of Clinical Oncology, 2009), and that by the time survivors are 45 years old, nearly 12 percent of those who received radiation plus anthracycline have developed clinical heart failure (Journal of Clinical Oncology, 2013). In a HemOnc today article, St. Jude’s Dr. Gregory Armstrong takes a closer look at these studies and others, such as a 2019 study that found high doses of radiation to even small volumes of the heart increase the risk for heart disease, as does very low dose radiation to a large volume of the heart (Journal of Clinical Oncology, 2019).
“One thing I like to say is that there’s likely no safe dose of anthracyclines,” said Dr. Armstrong. “I think when we look at [the radiation studies], we can also say there’s likely no safe dose of chest-directed radiation.”
At Children’s Cancer Cause, we have been closely following the issue of cardiotoxicities in childhood cancer survivors and advocating for safer, less toxic therapies for over two decades.
This September, we’re taking our advocacy a step further by hosting an FDA-approved Externally-Led Patient-Focused Drug Development (EL-PFDD) meeting on Reducing Cardiac Late Effects in Pediatric Cancer Survivors. This virtual conference is an important opportunity for survivors and caregivers to educate representatives of the FDA, academic researchers, clinicians, and biopharmaceutical companies about personal experiences managing the impact of cardiac late effects on daily living and long-term health.
Registration is now open for the September 15th meeting, and we encourage survivors and caregivers to register even if you (or your loved one) are not currently experiencing symptoms of cardiac late effects.