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Global Cardio-Oncology Summit brings together cardiologists, oncologists
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Building on the success of prior meetings in Nashville, Tennessee; Vancouver, British Columbia and London, the fourth annual Global Cardio-Oncology Summit, or GCOS, was held in Tampa, Florida, on Sept. 27 and 28. This year’s meeting was co-hosted by the International Cardio-Oncology Society, the Canadian Cardiac Oncology Network and the British Cardio-Oncology Society, in partnership with Moffitt Cancer Center and the University of South Florida as the academic institutional sponsors. Michael G. Fradley, MD, a cardiologist from Moffitt Cancer Center and University of South Florida, and Roohi Ismail-Khan, MD, a medical oncologist from the same institutions, served as co-chairs of this event.
This year’s GCOS meeting convened more than 360 attendees from across the globe to learn from experts in the field of cardio-oncology and to network with colleagues interested in this discipline, making it the largest dedicated cardio-oncology meeting in the world. Although cardiologists remain the dominant profession represented at the meeting, one-third of participants were from a primarily oncology background, and one-third were nonphysicians, which speaks to the collaborative, multidisciplinary nature of this specialty as well as the remarkable growth and interest in the field.
Patient-centered practice
Susan Dent, MD (Duke University), delivered an opening plenary lecture focusing on the past, present and future of cardio-oncology. Then, two inspirational patients presented their own experiences with cardio-oncology complications. Their powerful testimonials served as poignant reminder that improving the health of our patients remains the primary reason for these scientific meetings.
Sagar Lonial, MD (Emory University), Michael Mauro, MD (Memorial Sloan Kettering), and Ismail-Khan presented novel treatments for multiple myeloma, chronic leukemias and breast cancer, respectively. These therapies are associated with a variety of toxicities from vascular disease to arrhythmias. Paul Nathan, MD (University of Toronto), Martine Extermann, MD, PhD (Moffitt Cancer Center), and Kathryn Ruddy, MD (Mayo Clinic), presented data on CV toxicity prevention and treatment in pediatric cancer survivors, geriatric patients and patients with high-risk genetic syndromes. Chiara Melloni, MD (Duke University), and Kristen Sanfilippo, MD (Washington University), debated the merits of direct oral anticoagulants in patients with cancer.
CV imaging is an essential component to the comprehensive care of cancer patients and an entire session was devoted to this topic, with presentations from Dinesh Thavendiranathan, MD (University of Toronto), and Aarti Patel, MD (University of South Florida). There was also significant emphasis on imaging in the session concentrating on malignancies with a direct effect on the heart. Ronald Witteles, MD (Stanford), presented on amyloidosis, Jonathan Strosberg, MD (Moffitt), discussed carcinoid heart disease and other neuroendocrine tumors, and Cardiology Today Imaging Section Editor W.Gregory Hundley, MD (Virginia Commonwealth University), focused on the clinical and imaging evaluation of benign and malignant cardiac tumors.
Leadership recognized
Also at the meeting, Daniela Cardinale, MD, PhD (European Institute of Oncology, Milan), was recognized for her significant contributions to the field of cardio-oncology with the Thomas Force Leadership in Cardio-Oncology Lecture. Thomas Force, MD, is a professor emeritus of medicine at Vanderbilt University. Force was a pioneer in the development of cardio-oncology as a discipline. His translational research focusing on the potential mechanisms for cardiotoxicity are seminal contributions to this field. Cardinale’s lecture focused on the achievements in the field of cardio-oncology over the last 2 decades, along with a vision for the future of the field.
Highlighting research, knowledge gaps
Substantial gaps remain in our knowledge of cardio-oncology, ranging from appropriate risk assessment and management strategies to the molecular mechanisms of cardiotoxicity. As such, research and investigation were highlighted at this year’s summit.
Howard McLeod, PharmD (Moffitt Cancer Center), presented data on genomics and personalized medicine to identify those at risk for cardiotoxicity and Laleh Amiri-Kordestani, MD (FDA), discussed the importance of incorporating cardio-oncology in clinical trial design. Bonnie Ky, MD (University of Pennsylvania), and Ana Barac, MD, PhD (Washington Hospital Center), presented their choices for the top 10 basic/translational and clinical cardio-oncology research studies from this past year. Nikhil Khushalani, MD (Moffitt Cancer Center), and Thomas Neilan, MD (Massachusetts General Hospital), discussed the evolving field of immunotherapy and associated cardiotoxicities including myocarditis. Finally, Fradley and Daniel Lenihan, MD (Washington University), debated the lack of a standardized approach to QT evaluation in oncology clinical trials and its potential effects on treatment recommendations.
More than 100 original investigations were accepted for poster presentations, with topics ranging from immunotherapy toxicity to genomics and proteomics to assess CV risk. Three young investigator finalists were chosen for oral presentations: Magid Awadalla, MBBCH, BAO (Massachusetts General Hospital), Martin Nicol, MD (Lariboisiere Hospital, France), and Cherie Dahm, MD (Vanderbilt), with Dahm announced as the winner of the competition.
Cardio-oncology program development
Many individuals in attendance were interested in developing and growing their own cardio-oncology programs. Saro Armenian, DO (City of Hope), presented a plenary lecture reconciling the different recommendations and consensus statements regarding the practice of cardio-oncology, while also highlighting gaps and deficiencies in the current level of knowledge and evidence. Richard Chazal, MD (past president of the American College of Cardiology; Lee Health, Florida), provided guidance for starting a community-based cardio-oncology program, followed by Alex Lyon, MD, PhD (Royal Brompton Hospital, London), who focused on cardio-oncology programs affiliated with academic medical centers. Javid Moslehi, MD (Vanderbilt), addressed cardio-oncology education and fellowship training, while Anecita Fadol, PhD, RN (MD Anderson Cancer Center), and Natalee Roper, RN, BSN (Moffitt), discussed the role of nursing in cardio-oncology.
Increasing a cardio-oncology program’s visibility within the community is essential for its overall success. This can be effectively accomplished using social media such as Twitter, as presented by Naveen Pemmaraju, MD (MD Anderson Cancer Center). Pemmaraju discussed the importance of social media in developing professional connections and disseminating information to both colleagues and patients. At the end of his plenary lecture, many participants created a Twitter handle and began tweeting about GCOS. After 2 days, the meeting hashtag #GCOS2018 and the disease hashtag #CardioOnc were both trending, demonstrating the power of this platform to promote the profession.
A look ahead
With record attendance, the success of GCOS 2018 was evident. Through this meeting, participants learned optimal CVD screening methods before, during and after cancer therapy, along with potential therapeutic options for effective long-term CVD management in cancer patients and survivors. The diversity of the participants speaks to the collaborative nature of the discipline and highlights the international appeal of the meeting.
As the sessions closed for 2018, Ludhmila Hajjar, MD, PhD (University of Sao Paulo, Brazil), presented the Brazilian cardio-oncology experience, which served as the perfect invitation to attend GCOS 2019 in Sao Paulo. This is the first time GCOS will be held in Latin America and will be an excellent opportunity to introduce the field of cardio-oncology to a new region of the world while also expanding the educational and scientific mission of GCOS.
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- Michael Fradley, MD, is director of the Cardio-Oncology Program and associate professor of medicine at the University of South Florida and Moffitt Cancer Center, Tampa. He can be reached at mfradley@health.usf.edu; Twitter: @dr_mike_fradley.
Disclosure: Fradley reports he serves on an advisory board for Novartis.