# Assessment of cardiotoxicity in Immunity Checkpoint Blockers and other cancer therapies

> **NIH VA I21** · IOWA CITY VA MEDICAL CENTER · 2022 · —

## Abstract

Background: Lung cancer is a leading cause of death from cancer death worldwide, and non-small-cell lung
cancer (NSCLC) accounts for 85% of all lung cancer cases. Advances in NSCLC treatment using tyrosine
kinase inhibitors (TKI) and immunity checkpoint blockers (ICB) have led to improved survival. However, there
is a growing concern that cardiotoxicity associated with novel cancer therapies may lead to premature
morbidity among survivors. Unfortunately, heart damage due to cardiotoxicity is often not recognized until
manifested through acute or chronic cardiovascular events.
Significance/Impact: Given their proven clinical efficacy in improving cancer outcomes and potential for
expanded use in VA patients, there is an urgent need to better understand the risk and impacts of
cardiovascular toxicity associated with use of TKI and ICB in clinical practice. The information gained from this
pilot study will enable the conduct of large-scale population-based studies to identify clinical manifestations of
cardiotoxicity, quantify the incidence of related cardiovascular disease over time, identify risk factors for
cardiotoxicity associated with specific treatments, duration, and dose, and explore biomarkers that may serve
as early warning signals of potential heart damage. Results may also facilitate research into cardiotoxicity
associated with other cancer therapies and other types of cancer.
Innovation: A significant challenge to population-based studies of cancer-related cardiotoxicity is the lack of
validated algorithms to identify cardiotoxicity in observational data sources that reflect real-world clinical
practice across multiple institutions. Therefore, developing and validating algorithms for quantifying and
monitoring cardiovascular events in patients receiving alternative therapies would facilitate population-based
research on the long-term effects of cancer treatments among survivors, and assist in long-term surveillance of
novel cancer therapies to supplement clinical trial data. Benefits of conducting this research in the VA include
the large number of veterans who receive care through the VA, the availability of clinical detail for all VHA
patients nationwide through the VA Informatics and Computing Infrastructure (VINCI), and the availability of an
NLP algorithm previously validated to extract echocardiogram results from clinical notes in VA medical records.
We will focus our pilot analysis on patients with NSCLC due to the limited prior research on cardiotoxicity in
patients with NSCLC.
Specific Aims: This pilot study will develop and validate operational definitions of cardiovascular events
representing potential clinical manifestations of cardiotoxicity to facilitate future investigations into cardiotoxicity
associated with ICB and TKI using a population-based framework. Specific Aims are: 1) Develop and validate
a structured algorithm for identifying cardiovascular events in patients who initiate NSCLC cancer therapy with
ICI, TKI, o...

## Key facts

- **NIH application ID:** 10249983
- **Project number:** 5I21HX003116-02
- **Recipient organization:** IOWA CITY VA MEDICAL CENTER
- **Principal Investigator:** MARY S VAUGHAN SARRAZIN
- **Activity code:** I21 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2022
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2020-09-01 → 2023-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10249983

## Citation

> US National Institutes of Health, RePORTER application 10249983, Assessment of cardiotoxicity in Immunity Checkpoint Blockers and other cancer therapies (5I21HX003116-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10249983. Licensed CC0.

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