Improved Risk Stratification in Patients with Haematological Malignancy by Novel Imaging and Biomarkers - a Pilot Study

Summary

Over 350,000 new cases of cancer occur in the UK each year. Cancer treatments are very good at treating cancer but they have side effects, which can include long-term damage to the heart. Heart damage of this kind can be reduced or reversed if it is identified early. However, current methods to detect this kind of damage are imperfect, sometimes only identifying a problem once irreversible heart damage has already occurred, and this impacts both the quality of life and life expectancy of cancer survivors.

Promising new tests like cardiovascular magnetic resonance imaging (CMRI) of the heart and blood tests to look for markers of heart damage may be able to identify this damage at an earlier stage than current methods. It may even allow us to predict which patients will be particularly susceptible to this kind of heart damage. If these methods prove effective, long-term heart damage due to cancer treatment could be significantly reduced or even avoided altogether, leading to improved quality of life and survival for patients receiving treatment for cancer.

Study progress

Study recruitment (25/25 patients) was completed on 26 July 2018 and the study was declared complete on 1 March 2019.  Input of CMR, echo and blood biomarker data is complete. Preliminary analysis of baseline and early MicroRNA data is complete. The interpretation of this and other non-invasive data is ongoing with the ultimate objective of identifying early non-invasive predictors of subsequent deterioration of LV systolic function using CMR. 

During the course of the project, we have developed close links between cardiology and oncology/haematology departments at UH Bristol and Southmead with an expanding awareness of cardio-oncology and a growing appetite to develop a local and regional cardio-oncology service. Furthermore, we have established academic links with Juan Carlos Plana in Houston, Texas, who is an expert in the field of cardio-oncology and has reviewed and contributed to study conduct and design. The final results of the study may help to develop this service further and is intended to act as a stimulus for additional research studies locally. Dr Kate Liang, plans to commence research in cardio-oncology in Bristol in the Summer of 2019.

Analysis is ongoing, so main findings and impact are to be determined.

Updated 31 March 2019