By Sara Nick
Cancer care has come a long way in recent decades, with some types achieving survival rates of 90% or more. But longer survival times have introduced new consequences: namely, common cancer treatments can lead to an increased risk of serious heart problems later on.
"Chemotherapy and radiation are lifesaving, but we're playing catch up on their long-term side effects," says cardiologist Jordan Ray, M.D., director of a new Cardio-Oncology Clinic at Mayo Clinic in Florida. The clinic aims to support heart health among cancer patients, and study who is most at risk for future cardiac issues.
Geneticist Nadine Norton, Ph.D., who has spent her career mapping genes that can help predict which patients are susceptible to various diseases, is leading a research effort to better understand this need. "We know cancer patients can go on to suffer from heart failure, but we don't know who is most vulnerable," she says. "If we're able to determine that someone is at risk, we can get a cardiologist involved in their care early on – and potentially adapt their treatment plan to minimize future issues."
She and a multidisciplinary team including cardiologist Carolyn Landolfo, M.D., and cardiovascular scientist DeLisa Fairweather, Ph.D., began by analyzing patient samples from the Mayo Clinic Biobank to test which rare genetic variants are associated with chemotherapy-related heart failure in breast cancer patients. They identified a gene that they believe could be connected. The potential role of this gene was then confirmed in a mouse model. Finally, Dr. Norton and colleagues discovered and tested a new drug compound that seems capable of inhibiting adverse cardiac effects in mice.
"Our data are preliminary, but seem promising," she says.
Dr. Norton hopes that a genetic test to predict the risk of cardiac side effects in cancer patients could soon be added to standard pharmacogenomic panels, which use individuals' unique genetic makeup as a factor in deciding which drugs to prescribe.
"If we can learn which genes contribute to heightened risk, we can take better take care of patients," she says.
To support this work and future projects, Drs. Norton and Ray have created a new cardio-oncology registry that will collect blood samples from patients in cancer remission who are experiencing heart issues. Samples from all three Mayo sites will undergo genetic analysis by Dr. Norton's team with the aim of refining risk models.
"The cardio-oncology clinic and these research projects are a testament to Mayo's collaborative approach," Dr. Ray says. "This work is a wonderful example of what we can achieve for patients when we recognize them as a whole, rather than the sum of each separate condition."
These projects are supported by a Team Science Award from Mayo's Cardiovascular Research Center, aimed at fostering collaboration in ways that can change the practice for cardiovascular disease.
Multidisciplinary team science is the hallmark of the Mayo Model of Research
Tags: basic science, biobank, cardiology, Carolyn Landolfo, collaboration, DeLisa Fairweather, discovery research, Findings, genetic testing, genetics, Jordan Ray, Mayo Clinic Cancer Center, Nadine Norton, News, oncology, pharmacogenomics