The Australia and New Zealand Cardio-Oncology Registry (ACOR): evaluation of chemotherapy-related cardiotoxicity in a national cohort of paediatric cancer patients.

Daniel Lapirow; Andre La Gerche; Claudia Toro; Emma Masango; Ben Costello; Enzo Porello; Louise Ludlow; Glenn Marshall; Toby Trahair; Marion Mateos; Jeremy Lewin; Jennifer Byrne; Rose Boutros; Rebecca Manudhane; John Heath; Julian Ayer; Melissa Gabriel; Thomas Walwyn; Jelena Saundankar; Jonathon Forsey; Ha Le; Kylie Mason; David Celermajer; Peter Downie; Roderick Walker; Lucy Holland; Michelle Martin; Lorna McLeman; Yonatan Diamond; Maurizio Marcocci; Susan Donath; Michael Cheung; David A Elliott; Rachel Conyers
Abstract
Cancer therapy related cardiac dysfunction (CTRCD) is an area of increasing focus, particularly during the survivorship period, for paediatric, adolescent and adult cancer survivors. With the advent of immunotherapy and targeted therapy, there is a new set of mechanisms from which paediatric and young adult patients with cancer may suffer cardiovascular injury. Furthermore, cardiovascular disease is the leading cause of morbidity and mortality in the survivorship period. The recently established Australian Cardio-Oncology Registry (ACOR) is the largest and only population-based cardiotoxicity database of paediatric and adolescent and young adult (AYA) oncology patients in the world, and the first paediatric registry that will document cardiotoxicity caused by chemotherapy and novel targeted therapies using a prospective approach. The database is designed for comprehensive data collection and evaluation of the Australian practice in terms of diagnosis and management of CTRCD. Using the ACOR registry critical clinical information will be collected regarding predisposing factors for the development of CTRCD, the rate of subclinical LV dysfunction and transition to overt heart failure, further research into protectant molecules against cardiac dysfunction and aid in the discovery of which genetic variants predispose to CTRCD. A health economic arm of the study will assess the cost/benefit of both the registry and cardio-oncology clinical implementation. Finally, an imaging arm will establish if exercise magnetic resonance imaging (CMR) and VO max testing is a more sensitive predictor of cardiac reserve in paediatric and AYA oncology patients exposed to cardiac toxic therapies. This article is protected by copyright. All rights reserved.2
Journal INTERNAL MEDICINE JOURNAL
ISSN 1445-5994
Published 16 Dec 2019
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Pages
DOI 10.1111/imj.14719
Type Journal Article
Sponsorship