A team of researchers at King’s College London have been awarded £850k to develop imaging tests that detect heart damage caused by cancer
Predicting heart damage after cancer treatment is complex. With an increasing number of cancer patients being treated sooner and surviving for longer, the risk of developing heart problems is becoming a concern. The injury process can be slow to develop, often taking years after cancer treatment before the patient becomes unwell.
Now, researchers from King’s College London, Imperial College London, the Royal Veterinary College, and The Francis Crick Institute have been awarded £851,134 from the British Heart Foundation to develop advanced imaging tests for the early detection of heart damage in cancer patients.
Detecting cardiotoxicity to improve treatment
Currently, the only way of detecting cardiotoxicity is to measure changes in how the heart contracts using MRI or ultrasound. However, these techniques are insensitive, only detecting cardiotoxicity when it is too late to treat effectively.
The researchers have received the funding to develop sensitive molecular imaging tests to see damage to the mitochondria (the energy-producing sub-units within our cells) which they think happens much earlier in the disease process.
The team aims to detect this damage using Positron Emission Tomography (PET) imaging to help patients get treated sooner and support personalised cancer treatment to minimise heart damage. The test may help accelerate new drug development to prevent or treat cardiotoxicity.
“We are delighted to have received this award from the British Heart Foundation and proud to have assembled this supergroup across King’s College London, Imperial College London, the Royal Veterinary College and The Crick. We’re hoping to not just detect heart disease in cancer patients earlier, when there’s a better chance of successful treatment, but also find out why some patients are more susceptible to this sort of injury than others. This could help us to tailor and monitor their cancer therapies according to their personal cardiac risk,” commented Dr Richard Southworth, Reader in Cardiac Molecular Imaging at the School of Biomedical Engineering & Imaging Sciences
Heart health and cancer treatments
Chemotherapy is highly effective at destroying cancer tumours and reducing the risk of cancer spreading; however, in high doses, it damages the heart. For example, chemotherapy can cause high blood pressure, abnormal heart rhythms called arrhythmias, symptoms of angina or heart failure, inflammation or damage to the muscle of the heart, and an increased risk of developing other health problems, such as diabetes.
To avoid causing heart damage, cancer specialists often prescribe low doses of chemotherapy, which is not as effective at destroying cancer cells.
Previous research from the British Heart Foundation focused on understanding how the chemotherapy drug doxorubicin can lead to heart failure, particularly through the role of an enzyme called NADPH oxidase. While only a small number of patients receive the maximum dose of doxorubicin, around seven in 100 at that level develop heart failure. In studies with mice, blocking NADPH oxidase protected against heart damage, suggesting the enzyme plays a key role in chemotherapy-induced heart failure.
The research highlighted two significant goals: first, to develop a safe drug that blocks the NADPH oxidase enzyme, potentially allowing high-dose chemotherapy without causing heart failure; and second, to create a non-invasive method to measure NADPH oxidase levels in the heart, which could help assess a patient’s risk of heart damage from chemotherapy and tailor treatment accordingly.
