Database aims to personalize chemotherapy and reduce long-term heart risks

Cancer patients shouldn't have to worry about trading in one disease for another, contends U of A researcher.

In a devastating win-lose scenario, some cancer patients are warned that the aggressive medicine they need to live is so powerful it may end up damaging organs and only serve to replace one death sentence with another.

U of A researcher and nursing oncologist Edith Pituskin is heading up the development of a database that aims to identify this risk in certain individuals, and eventually give doctors a decision-making tool that supports personalized, safer chemotherapy treatment.

"Better treatments are curing patients of cancer, but up to 20 per cent of people receiving chemotherapy for breast and other aggressive cancers are at risk of suffering damage to the heart, lungs, blood vessels and muscles-sometimes with fatal consequences," she said.

In phase one of the Cardiotoxicity Prevention Research Initiative (CAPRI), Pituskin's team, which includes a collaboration with oncologist and cardiovascular specialists in Edmonton and Calgary, will begin collecting data from cancer patients at the Cross Cancer Institute and the Tom Baker Cancer Centre.

"Our goal is to get information from 2,500 breast cancer patients and begin assessing it for cardiovascular risk factors, like smoking, family history of heart diseases and lack of exercise." She added that this is a first time a phenotype, or risk profile, will be developed.

Once that is accomplished, the team will embark on phase two-a multimillion dollar genome application. In that phase, risk profiles will be matched against genetic information from samples at the Alberta Cancer Research Biobank. The goal is to identify genes that protect or promote cardiovascular disease in cancer patients, she explained.

"In the not too distant future, CAPRI will lead to a system that enables the treatment team to identify, based on a simple blood test, who is at risk of major complications from chemotherapy and possibly alter the therapy or start another intervention early," said Pituskin.

For example, previous research by Pituskin and Ian Paterson, a cardiologist in the U of A's Department of Medicine, showed that heart medications taken during certain intensive chemotherapy treatments can reduce the risk of serious cardiovascular damage in patients with early-stage breast cancer.

"The ultimate goal is to give treatment teams a point-of-care decision-making tool," she said, adding that she hopes that once cancer-free patients are discharged to the community, practitioners can use to CAPRI to follow those who are at risk of future heart failure more closely and prevent future heart failure, she added.

Funding for the initiative is being provided by Alberta Innovates Precision Health.