TY - JOUR
T1 - Integrating CardioOncology Across the Research Pipeline, Policy, and Practice in Australia—An Australian Cardiovascular Alliance Perspective
AU - Singleton, Anna C.
AU - Redfern, Julie
AU - Diaz, Abbey
AU - Koczwara, Bogda
AU - Nicholls, Stephen J.
AU - Negishi, Kazuaki
AU - La Gerche, Andre
AU - Playford, David
AU - Conyers, Rachel
AU - Cehic, Daniel A.
AU - Garvey, Gail
AU - Williams, Trent D.
AU - Hunt, Lee
AU - Doyle, Kerry
AU - Figtree, Gemma A.
AU - Ngo, Doan T.M.
AU - Sverdlov, Aaron L.
AU - on behalf of the Australian Cardiovascular Alliance Cardio-Oncology Working Group
N1 - Funding Information:
The Implementation and Policy flagship could leverage engagement with government, industry, and research partners, and data from other flagships (such as Drug Discovery, Clinical Trials, and Big Data) to advocate for the development of a national best practice policy, and implementation into practice. For example, several dedicated cardio-oncology programs now exist across Australia, with data collection that spans the seven ACvA flagships. One example is the Newcastle Cardio-Oncology Program (established in 2017) in the Hunter New England Local Health District in New South Wales that incorporates fundamental discovery studies (preclinical in vitro and ex vivo and patient-derived human inducible pluripotent stem cell–derived cardiomyocytes), drug discovery and repurposing studies, translational and clinical research, and clinical service delivery for a comprehensive bench-to-bedside approach. Thus far, the program has been used by more than 550 patients attending over 2,200 visits, with over 20,000 patients in the database. Service delivery data from this cardio-oncology program resulted in direct positive effects on patients’ cardiac health outcomes: of the first 250 patients referred to the program’s dedicated cardio-oncology clinic, only 9% required interruption or change in cancer therapy due to a cardiac issue [ 69 ]. Patients found the program helpful for education, health management, and continuity of care, and felt more satisfied with their health care team and patient–clinician communication [ 70 ]. Results also revealed challenges in accessing cardio-oncology care, especially for patients living in regional, rural, and remote locations [ 71 ], which led to expansion of the service to three regional and rural sites (funded by a 2023 Cancer Institute NSW Accelerated Research Implementation Grant). Moreover, the fundamental science arm of the program has successfully engaged with industry partners aiming to deliver an anticancer drug with cardioprotective properties [ 72 ], leading to upcoming human trials [ 73 ]. In 2022, the Newcastle Cardio-Oncology Program became the first cardio-oncology program in Australia to receive the Top (Gold) Tier accreditation as a “Center of Excellence in Cardio-Oncology” from the International Cardio-Oncology Society in recognition of the program’s excellence in clinical care, research, and education [ 74 ].
Funding Information:
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. However, the following authors are funded by competitive grants and fellowships: A.C.S. is supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Level 1 Investigator Grant EL1 (Award ID GNT2017575); J.R. is supported by an NHMRC Leadership Level 2 Investigator Grant (Award ID GNT1143538); A.D. is supported by a University of Queensland Faculty of Medicine Fellowship; G.G. is supported by an NHMRC Leadership Level 2 Investigator Grant (Award ID 1176651); G.F.’s salary is funded by an NHMRC Leadership Level 2 Investigator Grant (Award ID GNT 2018194); K.D. is funded by the Australian Cardiovascular Alliance; and D.T.M.N. and A.L.S. are supported by the National Heart Foundation of Australia Future Leader Fellowship (Award Identifications 104814 and 106025, respectively).
Publisher Copyright:
© 2024 The Authors
PY - 2024/5
Y1 - 2024/5
N2 - Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of cardiovascular risk factors have resulted in cardiovascular disease (CVD) being one of the leading causes of non-cancer-related death and disability among cancer survivors. International guidelines outline the standards of care for CVD risk surveillance and management. However, Australian cardio-oncology policies and clinical guidelines are limited. There is increasing growth of cardio-oncology research in Australia and support from leading Australian professional bodies and advocacy and research networks, including the Cardiac Society of Australia and New Zealand, the Clinical Oncology Society of Australia, the National Heart Foundation of Australia, and the Australian Cardiovascular Alliance (ACvA). Thus, opportunities to drive multidisciplinary cardio-oncology initiatives are growing, including grant funding, position statements, and novel research to inform new policies. The ACvA has a unique flagship structure that spans the translational research pipeline from drug discovery to implementation science. This article aims to highlight how multidisciplinary cardio-oncology innovations could intersect with the seven ACvA flagships, and to showcase Australian achievements in cardio-oncology thus far. We summarise eight key priority areas for future cardio-oncology research that emerged. These strategies will strengthen cardio-oncology research and care in Australia, and drive new guidelines, policies, and government initiatives to ensure equity in health outcomes for all cardio-oncology patients.
AB - Over 18 million people worldwide were diagnosed with cancer in 2020, including over 150,000 people in Australia. Although improved early detection and treatment have increased the survival rates, cardiotoxic treatment and inadequate management of cardiovascular risk factors have resulted in cardiovascular disease (CVD) being one of the leading causes of non-cancer-related death and disability among cancer survivors. International guidelines outline the standards of care for CVD risk surveillance and management. However, Australian cardio-oncology policies and clinical guidelines are limited. There is increasing growth of cardio-oncology research in Australia and support from leading Australian professional bodies and advocacy and research networks, including the Cardiac Society of Australia and New Zealand, the Clinical Oncology Society of Australia, the National Heart Foundation of Australia, and the Australian Cardiovascular Alliance (ACvA). Thus, opportunities to drive multidisciplinary cardio-oncology initiatives are growing, including grant funding, position statements, and novel research to inform new policies. The ACvA has a unique flagship structure that spans the translational research pipeline from drug discovery to implementation science. This article aims to highlight how multidisciplinary cardio-oncology innovations could intersect with the seven ACvA flagships, and to showcase Australian achievements in cardio-oncology thus far. We summarise eight key priority areas for future cardio-oncology research that emerged. These strategies will strengthen cardio-oncology research and care in Australia, and drive new guidelines, policies, and government initiatives to ensure equity in health outcomes for all cardio-oncology patients.
KW - Cardio-oncology
KW - Cardiology
KW - Public health
KW - Translational research
UR - http://www.scopus.com/inward/record.url?scp=85185481804&partnerID=8YFLogxK
U2 - 10.1016/j.hlc.2024.01.011
DO - 10.1016/j.hlc.2024.01.011
M3 - Article
C2 - 38336544
AN - SCOPUS:85185481804
SN - 1443-9506
VL - 33
SP - 564
EP - 575
JO - Heart Lung and Circulation
JF - Heart Lung and Circulation
IS - 5
ER -