# [18F]F-AraG as an imaging biomarker for early diagnosis and monitoring of cardiotoxicity related to doxorubicin and immune check point inhibitor therapy

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · 2022 · $728,416

## Abstract

Project Summary (Abstract)
Cardiovascular complications caused by cancer therapy are a major cause of morbidity and mortality in cancer
patients and survivors. Cardiotoxicity of traditional cancer therapies, such as anthracyclines, as well as more
selective, targeted therapies, have been well documented and underlying mechanisms of cardiac injury
thoroughly studied. Cardiovascular toxicity of a newer, very promising therapy, immune checkpoint inhibitors
(ICI), is not well delineated and presents a significant diagnostic and patient management challenge for cardio-
oncologists. Furthermore, cardiac damage of increasingly used chemo/ICI combinatorial therapies has not been
investigated to any significant extent. Due to the advantage of being noninvasive, cardiac imaging is the most
commonly used technique for monitoring cardiac function during and after cancer therapy, but current methods
lack molecular specificity and are unable to detect cardiotoxicity sufficiently early to allow timely intervention and
amelioration of cardiovascular risks. Inability of currently used imaging methods to detect subclinical cardiac
involvement represents a major bottleneck for prevention and better management of cardiac complications in
cancer patients and survivors. Positron emission tomography (PET) imaging using agents that target early
indicators of cardiovascular toxicity could offer a powerful and highly specific noninvasive tool for detection of
subclinical cardiac toxicity associated with traditional as well as ICI cancer therapy. We propose to investigate
[18F]F-AraG, a PET agent with a unique ability to evaluate a pathophysiological centerpiece of both ICI
and anthracycline-related cardiotoxicity - activated T cells and mitochondrial function in cardiomyocytes
- as an imaging biomarker for early diagnosis and monitoring of cardiotoxicity associated with ICI as
well as chemotherapy. The immediate goal of this project is to investigate the correlation between myocardial
[18F]F-AraG uptake and processes that drive ICI and anthracycline (doxorubicin) cardiotoxicity. The long-term
goal is development of a highly sensitive and specific technique to guide interventions in early, subclinical phases
of cardiac dysfunction. The proposed research will deliver a unique and clinic-ready imaging approach to
address a key clinical problem in cardio-oncology: noninvasive detection of cardiotoxicity at an early
stage to allow therapeutic interventions and reduction of cardiovascular risks. The proposed imaging
technique is applicable to assessment of cardiotoxicity associated with different cancer therapies, including ICI-
and combinatorial chemo/ICI approaches for which no diagnostic approach currently exists.

## Key facts

- **NIH application ID:** 10340980
- **Project number:** 1R01HL160688-01
- **Recipient organization:** UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
- **Principal Investigator:** Jelena Levi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $728,416
- **Award type:** 1
- **Project period:** 2022-01-21 → 2026-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10340980

## Citation

> US National Institutes of Health, RePORTER application 10340980, [18F]F-AraG as an imaging biomarker for early diagnosis and monitoring of cardiotoxicity related to doxorubicin and immune check point inhibitor therapy (1R01HL160688-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10340980. Licensed CC0.

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