CNIC hosts the foremost global Cardio-Oncology summit
The International Cardio-Oncology Society (ICOS), the Spanish Society of Cardiology (SEC), the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Haematology and Haemotherapy (SEHH) organised the Global Cardio-Oncology Summit in Madrid.
It is known that at least one in every three patients with cancer develops cardiovascular toxicity. This has given rise to a new discipline, cardio-oncology, which deals with the cardiovascular needs of cancer patients and optimises their care employing a multidisciplinary approach. “This is a sub-speciality of medicine centred on providing comprehensive cardiovascular care for patients with cancer from diagnosis to post-treatment survival”, explains Dr Teresa López, coordinator of SEC’s Cardio-Oncology Working Group and organizer of the Global Cardio-Oncology Summit hosted by the International Cardio-Oncology Society (ICOS), the Spanish Society of Cardiology (SEC) through its Cardio-Oncology Working Group, the Spanish Society of Medical Oncology (SEOM) and the Spanish Society of Haematology and Haemotherapy (SEHH), whose first symposium was held at the Spanish National Centre for Cardiovascular Research (CNIC).
Last year saw publication of the European Society of Cardiology’s guidelines, which Dr Susan Dent, President of the International Cardio-Oncology Society defines as a ‘major milestone’. “The guidelines also highlight some of the existing knowledge gaps in cardio-oncology, which is important because it shows that we need more research in this field, so I hope that these guidelines not only provide recommendations for the community, but also stimulate research to find a response to the unanswered questions.”
During the symposium, which focused on translational and basic research, in a session organized by the journal JACC: CardioOncology with participation of the journal’s editor-in-chief, Dr Bonnie Ky, Dr Valentín Fuster, General Director of CNIC noted, “Unfortunately, the toxicities associated with chemotherapeutic treatments in cancer patients are a common occurrence.”
Dr Fuster’s interest in cardio-oncology began many years ago. “We decided this was an important area which is why, when I was editor-in-chief at JACC, we thought we should launch JACC: CardioOncology.”
Dr Fuster also pointed out that in oncology and cardiology, detection of disease currently occurs when it is very advanced. “Chemotherapy has proved its effectiveness for cancer, but at the same time, it can cause problems for the heart. We must go further, and we have to attempt to eliminate cancer while preserving cardiovascular health.”
We know risk factors exist which affect both diseases, and that’s why we have to go one step further and be able to identify these patients during the initial phases of their diseases. Dr Fuster advocates identification of people at very early, initial stages, before the cardiovascular disease or cancer have really developed. In his view, the future of cardio-oncology lies in “being able to prevent, rather than treat, both.”
Along similar lines, Dr Susan Dent indicates that cardio-oncology has a promising future. “I see more healthcare professionals becoming involved in this field, not only cardiologists and oncologists, but also primary care professionals, nurses, pharmacists or exercise physiologists. All these people form an important part of the medical care team necessary to care for our patients and offer the best possible health in the future.”
She believes that one of the problems that needs tackling are differences between centres in terms of follow-up practices. She comments, “…what we really need is to come together as an international community, follow the most recent European Society of Cardiology guidelines and attempt to focus on how we care for patients and, more importantly, when we do so. We are making efforts to compile data on these patients from different centres to determine what we are doing and what the results are for our patients.”
The symposium on translational and basic research held at CNIC was the first of its kind to take place in Europe, bringing together researchers from the different specialist fields who care for cancer patients. Coordination between these professionals enables basic researchers to focus on subjects that are relevant for improving patient care and gives clinicians access to this information to validate the outcomes of basic research.
“In cardio-oncology we need greater depth of knowledge about the mechanisms of cardiovascular toxicity in antitumoral treatments in order to develop risk scores and personalised prevention strategies,” explains the Coordinator of SEC’s Cardio-Oncology Working Group.
Worthy of note, among other interesting topics dealt with during the research symposium and the rest of the conference, was the session on immunotherapy related to the SIR-CVT project, a registry set up by SEC, SEOM and CNIC: RESILIENCE, one of CNIC’s star projects, led by Dr Borja Ibáñez, and a talk on how anthracyclines accelerate cellular ageing and, therefore, produce heart failure.
Dr Borja Ibáñez, coordinator of the RESILIENCE project and CNIC Scientific Director, explained how currently “there are two great unresolved clinical needs related to the cardiotoxicity associated with using anthracycline: the lack of therapies to prevent or cure the condition, and the absence of specific markers that identify the problem in its first stages.”
Moreover, cardio-oncology does not just focus on preventing toxicity. As highlighted at another of the most important sessions, an increasing number of patients who suffer cardiovascular diseases and go on to develop cancer. This is why cardiologists need to organize their screening strategies for cancer and collaborate with oncologists so that these high-risk patients can benefit from treatments for which they are generally not eligible precisely because of their high risk.
The symposium also looked at the latest developments for women with cancer and cardiovascular disease, and how to sustainably organize the monitoring of children and adults who survive cancer.
“The longevity and quality of life of cancer survivors has drastically improved in recent years, thanks in great part to the development of new therapeutic options against cancer. Although the number of cancer survivors has increased, so has the incidence and prevalence of toxicity related with antitumoral treatments. So much so, that cardiovascular toxicities related with antitumoral treatments have become a frequent challenge for both patients and doctors,” explains Dr Teresa López.
The symposium provided an overview of the latest developments for women with cancer and cardiovascular disease, and how to sustainably organize monitoring of children and adult cancer survivors.
As representative of the SEHH, Dr Raúl Córdoba Mascuñano, member of its Board of Directors, highlights, “We need to adopt a truly multidisciplinary approach for all patients with cancer, above all for those who will be long-term survivors, for whom we need to provide comprehensive healthcare before, during and after the end of treatment.”
Dr Javier de Castro, SEOM vice president and member of the Cardio-Oncology Working Group points out, “In its role as guarantor of comprehensive care for oncological patients, SEOM considers it important to preserve the cardiovascular health of cancer patients. To do so, a basic element is multidisciplinary work alongside cardiologists and other specialists, not only for the prevention of potential cardiovascular side effects triggered by oncological therapies, but also to foster quality of life beyond the oncological disease.”
For Javier de Castro, “Holding the ICOS conference in Spain represents a landmark that shows the scientific level achieved by Spanish cardio-oncology and the degree of cooperation between different professionals”.
