# Enhancing Understanding of Harms and Benefits of Cardiac Monitoring During Breast Cancer Therapy

> **NIH NIH K23** · SLOAN-KETTERING INST CAN RESEARCH · 2020 · $176,389

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Yu, an adult cardiologist at Memorial Sloan Kettering (MSK) with advanced training in echocardiography,
has demonstrated a strong commitment to developing a career as a clinical investigator in cardio-oncology. His
long-term goal is to lead efforts to develop evidence-based strategies for the prevention, detection, and
management of cancer therapy-associated cardiotoxicity in order to mitigate the competing cardiovascular
causes of morbidity and mortality in cancer survivors. The career development and training plans outlined in
this application have been tailored to provide Dr. Yu with the necessary skills, structured mentoring, and
research experience to meet his long-term research and career goals and ensure a successful transition to
independence as a clinician scientist. Members of a multidisciplinary mentorship team comprised of nationally
recognized leaders in survivorship, cardio-oncology, and health outcomes are committed to providing close
supervision and guidance to Dr. Yu in achieving all of the career development, training, and research
objectives of this proposal. The overall objective of the scientific aspect of this proposal is to better understand
the harms and benefits associated with cardiac monitoring during trastuzumab therapy. Cardiotoxicity is a well
recognized adverse effect of trastuzumab therapy used to treat HER2-positive breast cancer. Clinical
guidelines for cardiac monitoring during trastuzumab therapy recommend routine serial assessments of left
ventricular ejection fraction (LVEF). However, evidence to support this one-size-fits-all recommendation for all
patients treated with trastuzumab is lacking, particularly given the growing trend in the use of non-anthracycline
trastuzumab-based regimens with safer cardiotoxicity risk profiles. There is also the potential harm that false-
positive results or clinically insignificant LVEF declines detected during routine cardiac monitoring will
unnecessarily lead to interruption or early termination of curative and life-saving breast cancer therapy and
result in worse cancer outcomes. The central hypothesis is that a strategy of limited cardiac monitoring among
women with a low cardiovascular risk profile and treated with a non-anthracycline trastuzumab-based regimen
will be safe and less costly. Dr. Yu will address this central hypothesis using two distinct and complementary
approaches. In Aim 1, he will capitalize on existing variations in the frequency of cardiac monitoring observed
at MSK to retrospectively examine the association between adherence to cardiac monitoring guidelines and
cardiotoxicity events. In Aim 2, acknowledging the limitations of a retrospective study design, he will
prospectively evaluate the safety and feasibility of a limited cardiac monitoring strategy in patients treated with
a non-anthracycline trastuzumab-based regimen. In Aim 3, he will estimate the healthcare utilization and costs
associated with guideline-based ve...

## Key facts

- **NIH application ID:** 9979796
- **Project number:** 5K23CA218897-04
- **Recipient organization:** SLOAN-KETTERING INST CAN RESEARCH
- **Principal Investigator:** Anthony Francis Yu
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $176,389
- **Award type:** 5
- **Project period:** 2017-08-01 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9979796

## Citation

> US National Institutes of Health, RePORTER application 9979796, Enhancing Understanding of Harms and Benefits of Cardiac Monitoring During Breast Cancer Therapy (5K23CA218897-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9979796. Licensed CC0.

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