# Predicting risk of cardiotoxicity among young and emerging adult breast cancer patients from treatment to survivorship

> **NIH NIH K01** · NORTHWESTERN UNIVERSITY · 2020 · $156,336

## Abstract

Breast cancer is the most common cancer among women and cardiovascular disease (CVD) is prevalent among
breast cancer survivors. This is due to shared risk factors between CVD and cancer, but also that breast
cancer therapies are often cardiotoxic, which may later cause heart failure (HF). Cardiotoxicity from breast
cancer chemotherapy affects between 10-20% of patients with enhanced risk in the presence of traditional
CVD risk factors. However, there is a significant gap in our knowledge of cardiotoxicity among the rapidly
growing population of young and emerging adult (YEA) breast cancer survivors, which comprise 5-12% of all
breast cancer diagnoses. As survival from breast cancer increases, exposure to cardiotoxic chemotherapies at
a younger age may enhance HF risk among YEA breast cancer survivors. Moreover, YEA breast cancer
patients are more likely to have gene mutations that may also impair cardiac tissue function combined with a
unique pattern of health behaviors and CVD risk factors. However, we are currently unable to predict which
patients are at highest risk of cardiotoxicity. Studies suggest that gene expression may refine identification of
women at increased risk of cardiotoxicity. To date, no studies examined whether combining gene expression
and genetic mutations with CVD risk factors can identify YEA patients at increased risk of cardiotoxic effects of
chemotherapy. To address this issue, I will complete the following specific aims: 1) Develop a predictive model
combining psychosocial and traditional CVD risk factors to identify YEA breast cancer patients at increased
risk of cardiotoxicity as defined by a decline in global longitudinal strain (GLS) or left ventricular ejection
fraction (LVEF); 2) Investigate if the risk factor profile at diagnosis is associated with trajectory of GLS and
LVEF during and after breast cancer treatment; and 3) investigate the impact of molecular biomarkers to risk
prediction models. We will recruit a longitudinal cohort of n=300 YEA breast cancer patients treated at
Northwestern Medicine. Among these participants, in a nested case-control design, we will select cases
diagnosed with decline in GLS during chemotherapy (n=50) with age-matched controls without cardiotoxicity
(n=50). For all participants, we will combine electronic health record (EHR) data with psychosocial and
traditional CVD risk factors at three timepoints. For the nested case-control study, we will additionally measure
gene expression at two timepoints. This directly informs my short-term career development goals to 1) Gain
experience in HF and CVD etiology, epidemiology, and risk factors; 2) Develop skills in machine learning and
bioinformatics approaches for prediction; and 3) Refine health informatics methods to integrate EHR with
epidemiologic and molecular data. The skills and pilot data generated through this K01 will enable me to
address the NHLBI compelling question (5.CQ.10) to reduce cardiac morbidity and mortality in canc...

## Key facts

- **NIH application ID:** 9953579
- **Project number:** 1K01HL152009-01
- **Recipient organization:** NORTHWESTERN UNIVERSITY
- **Principal Investigator:** Elizabeth Anne Hibler
- **Activity code:** K01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $156,336
- **Award type:** 1
- **Project period:** 2020-05-06 → 2025-02-28

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9953579

## Citation

> US National Institutes of Health, RePORTER application 9953579, Predicting risk of cardiotoxicity among young and emerging adult breast cancer patients from treatment to survivorship (1K01HL152009-01). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9953579. Licensed CC0.

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