The International CardiOncology Society An Update for 2014 Daniel J Lenihan, MD Professor, Division of Cardiovascular Medicine Director, Clinical Research Vanderbilt University

The International CardiOncology Society An Update • Exactly what does this society mean?

• How do we do things?

• What are our goals?

• How do we achieve them?

• Is there really a future for this?

ICOS is:

• A collection of interested providers focused on improving cardiac health in cancer patients • A mix of academic, practice, governmental, regulatory, and industry professionals • Committed to our patients wherever they are

The International CardiOncology Society An Update • Exactly what does this society mean?

• How do we do things?

• What are our goals?

• How do we achieve them?

• Is there really a future for this?

We do things in many ways:

• Day to day improvement in our practices • Monthly webinars available to all • Periodic presentations at major meetings • Annual ICOS congresses • Development of current “Best Practice” • Data review for ongoing early phase and late phase clinical trials • Ongoing participation in major professional society efforts • Ongoing individual and multicenter research • Consistent involvement with regulatory agencies in many countries

The International CardiOncology Society An Update • Exactly what does this society mean?

• How do we do things?

• What are our goals?

• How do we achieve them?

• Is there really a future for this?

ICOS goals

• Research – Engage large databases – Cardiac safety endpoint adjudication – Hypothesis testing research • Education – Provider case review – Patient directed – Professional meetings – Industry/regulatory webinars – Trainee organization • Advocacy • Patients/families • Providers • Be a Resource • Up to Date information • Identify Goals for the future • Provide innovation • Be an example of collaboration

Number of PUBMED articles on Cardio-Oncology 150 100 50 0 400 350 300 250 200 1971 2014

www.oncoreview.pl

The International CardiOncology Society An Update • Exactly what does this society mean?

• How do we do things?

• What are our goals?

• How do we achieve them?

• Is there really a future for this?

PREDICT Study: A multicenter study in P atients undergoing anth R acycline-based chemotherapy to assess the E ffectiveness of using biomarkers to D etect and I dentify C ardiotoxicity and describe T reatment

Daniel J Lenihan, MD Professor, Division of Cardiovascular Medicine Vanderbilt University CCOP Annual Meeting 2010

Total Accrual: 597 patients

In the case of HER2+ breast cancer, treatment clearly benefitted the disease but came at a cost Slamon D et al; NEJM 2011:365:1273-83

The effect of time for initiation of HF therapy and the percent of patients who improve

100 80 60 40 20 0 64%

1-2 (n=75)

28% 7% 0% 0% 0% 0%

2-4 (n=35) 4-6 (n=20) 6-8 (n=12) 8-10 (n=8) 10-12 (n=7) >12

months

(n=44) D Cardinale, et al. JACC 2010, jan 26.

In regards to

Ischemic

insults, we have a paradigm

Kloner et al, Circ 2001; p2981

Statin therapy prior to and during chemotherapy was protective JACC 2012, p 2384

Prevention of Cardiotoxicity is possible Bosch, X et al, JACC 2013, p 2355

Are there things on the cancer therapy horizon that could be concerning for cardiomyopathy?

There is a balance between protein synthesis and degradation Monte S. Willis, M.D., Ph.D., and Cam Patterson, M.D., M.B.A. NEJM 2013;368:455-64.

Dick,LR and Flemming,PE Drug Discovery Today ;15 (5/6) March 2010

The International CardiOncology Society An Update • Exactly what does this society mean?

• How do we do things?

• What are our goals?

• How do we achieve them?

• Is there really a future for this?

A Paradigm for Cardiology Oncology Cooperation Kouri M et al. Circulation 2012

ICOS=

A public, private, patient, provider, regulatory, governmental PARTNERSHIP

www.icosna.org