Screening and Cardio-surveillance of Cancer Patients Undergoing Immune Checkpoint Blockade
When immunotherapy was introduced in oncology, it revolutionized treatment for many cancers, including some that had no real treatment prior. However, it brought with it a hidden heart risk, and Dr. Sanjeev Francis of MaineHealth received his pilot award to try and detect these risks earlier. Oncologists noted that a small percent of patients receiving immunotherapies experience severe cardiovascular complications, and myocarditis is the one Dr. Francis says they worry about the most. This condition has high morbidity and mortality rates, even when detected early, so finding out which patients are at risk before symptoms start is critical. As immunotherapies are being used for more and more cancers, and multiple therapies are being used simultaneously in individual patients, the risk of this rare but serious cardiotoxicity is a growing concern. The project aims to answer two main questions: Is there a better way to understand who is at risk of myocarditis, and is there any signal that can be detected clinically using advanced cardiac monitoring that can alert clinicians to at risk patients before they start to show symptoms? Dr. Francis and his team recently enrolled the first patient and aim to enroll 25 total from across both urban and rural areas, which is something he feels is critical. As a clinician in our region, Dr. Francis believes the opportunity to enroll patients who have historically not participated in clinical research at this level fulfills part of the mission of our health system, so his project is focused on recruiting and supporting patients across the state of Maine, reaching to its most rural areas.
“The great part about the CTR program is that it created these connections with our translational scientists, and as a result of that, we used this concept to draft a larger grant that brought together more collaborators in Maine as well as partners outside of the state. This was all made possible because the CTR created an environment where we were thinking creatively about how we look at this clinical problem from different dimensions. So even before we enrolled our first patient, we had already taken the step of thinking bigger and expanding the project into bigger applications."