- Lab Pages
- Ky Laboratory
Founders Professor of Cardio-Oncology
Professor of Medicine and Epidemiology
Division of Cardiovascular Medicine
Senior Scholar, Center for Clinical Epidemiology and Biostatistics
Director, Thalheimer Center for Cardio-Oncology of the Abramson Cancer Center
Director, Penn Center for Quantitative Echocardiography
Location: Smilow TRC 11-105
Admin: Desuana Dubose
Cancer and cardiovascular disease are two of the largest contributors to morbidity and mortality globally. Despite this tremendous public health burden, there are fundamental gaps in our understanding of disease mechanisms and in the application of evidence-based strategies for the clinical care of this growing population.
The Ky research lab is a National Institutes of Health-and American Heart Association-funded, internationally recognized program that focuses on advancing the cardiovascular health of patients living with and beyond cancer through clinical science. Our research focuses on understanding the underlying mechanisms and predictors of cancer therapy cardiotoxicity and heart failure, and translating this understanding to the clinical care of patients. Our programmatic objectives are to use innovative strategies in detailed cardiovascular phenotyping to define and mitigate an individual cancer patient’s risk of developing subsequent cardiovascular disease.
Our ongoing projects focus on determining the role of mechanistic markers, including circulating biomarkers and imaging-derived markers of cardiac mechanics in understanding and predicting adverse cardiovascular outcomes. Our research also focuses on social determinants of health and health disparities through understanding and mitigating the inequities in cardiovascular disease in cancer patients. We have established multiple patient oriented cohort studies and Phase I-II clinical trials across the Abramson Cancer Center and University of Pennsylvania Cancer System to achieve our programmatic goals.
Cardiotoxicity of Cancer Therapy (CCT) (NCT01173341)
The overall objective of this longitudinal prospective cohort study is to determine the role of individual patient characteristics, mechanistic biomarkers, and novel echocardiographic measures of cardiac function in predicting the short- and long-term cardiovascular disease risk in women with breast cancer receiving potentially cardiotoxic therapy.
Cardiotoxicity of Cancer (CCT2) (NCT 05078190)
The objectives of this longitudinal prospective cohort study in women with breast cancer are to determine the associations between individual and structural social determinants of health (SDOH) and cardiotoxicity risk, and how this may differ according to race. A sub-study of this protocol includes a detailed study of allostatic load, characterized as the “wear and tear” from chronic levels of stress placed on physiological systems.
Cardiotoxicity of Prostate Cancer Therapy (PCT) (NCT05096338)
The primary objectives of this longitudinal prospective cohort study in men with prostate cancer are to determine the associations between individual and structural SDOH and cardiotoxicity risk, and how this may differ according to race. A sub-study of this protocol also includes a detailed study of allostatic load.
Risk-Guided Cardioprotection with Carvedilol in Breast Cancer Patients (CCT Guide Pilot) (NCT04023110)
This is a Phase I, single-center, randomized clinical trial that seeks to determine if a risk guided treatment strategy, as determined by a clinical risk score, that randomizes elevated cardiovascular risk breast cancer patients prior to doxorubicin and/or trastuzumab to carvedilol or usual care is safe, tolerable, and feasible.
Cardioprotection with Lymphoma or Breast Cancer Treated with Anthracyclines (NTproBNP-Guide) (NCT04737265)
This is a Phase I, multi-center, randomized trial of a biomarker-guided strategy using NT-proBNP to identify and treat patients at elevated risk of anthracycline therapy-related cardiotoxicity. The primary objective of this study is to determine if a biomarker guided strategy is feasible and well-tolerated in breast cancer or lymphoma patients treated with doxorubicin.
Cardiotoxicity in Breast Cancer Patients Treated with Proton or Photon Radiotherapy (RadComp Ancillary) (NCT04361240)
The overall objectives of this ancillary study to the RadComp clinical trial are to determine how early subclinical measures of cardiovascular injury and dysfunction differ according to radiation therapy type (proton vs photon) and which radiation therapy dose-volume parameters influence these markers.
Cardiotoxicity in Non-Metastatic Lung Cancer Patients Treated with Chemoradiation Therapy (CLARITY) (NCT04305613)
CLARITY is a multi-center, longitudinal prospective cohort study of lung cancer patients treated with radiation therapy with the objectives being to determine associations between radiation therapy dose-volume metrics and changes in biologic and imaging markers of cardiovascular function. We aim to determine the prognostic value of these markers as indicators of adverse cardiovascular outcomes.
Cancer Therapy Risk-Reduction with Intensive Systolic BP Management (CARISMA) (NCT04467021)
The overall objective of this Phase II clinical trial is to determine the feasibility of an Intensive (SBP< 120mmHg) Intervention versus Standard Care (SBP< 140mmHg) Non-Intervention approach to blood pressure (BP) control in metastatic renal cell and thyroid cancer patients initiating vascular endothelial growth factor receptor tyrosine kinase inhibitors.
Data Science, Deep Phenotyping, and Patient-Oriented Research in Cardio-Oncology
We are leveraging the electronic medical records (EMR) of the University of Pennsylvania Health System to determine the impact of race and the SDOH in cardio-oncology through a detailed analysis of patient-level data. We use the EMR to derive large breast and prostate cancer cohorts of patients receiving cardiotoxic cancer therapies and define the individual and structural SDOH and associations with cardiovascular clinical outcomes.
Cardiovascular Implications of Vascular Endothelial Growth Factor Inhibition Among Adolescents/Young Adults in ECOG-ACRIN E2805. Bottinor WJ, Flamand Y, Haas NB, ONeill AM, DiPaola RS, Subramanian P, Cella D, Hundley WG, Wagner LI, Salsman JM, Ky B. J Natl Compr Canc Netw. 2023 Jul;21(7):725-731.e1. doi: 10.6004/jnccn.2023.7018.PMID: 37433436 Clinical Trial.
Risk of Cardiovascular Events Among Patients With Head and Neck Cancer. Sun L, Brody R, Candelieri D, Lynch JA, Cohen RB, Li Y, Getz KD, Ky B. JAMA Otolaryngol Head Neck Surg. 2023 Jun 22:e231342. doi: 10.1001/jamaoto.2023.1342. Online ahead of print. PMID: 37347472
Association of Preexisting Heart Failure With Outcomes in Older Patients With Diffuse Large B-Cell Lymphoma.Upshaw JN, Nelson J, Rodday AM, Kumar AJ, Klein AK, Konstam MA, Wong JB, Jaffe IZ, Ky B, Friedberg JW, Maurer M, Kent DM, Parsons SK. JAMA Cardiol. 2023 May 1;8(5):453-461. doi: 10.1001/jamacardio.2023.0303. PMID: 36988926
Statins and Left Ventricular Ejection Fraction Following Doxorubicin Treatment.Hundley WG, D'Agostino R Jr, Crotts T, Craver K, Hackney MH, Jordan JH, Ky B, Wagner LI, Herrington DM, Yeboah J, Reding KW, Ladd AC, Rapp SR, Russo S, O'Connell N, Weaver KE, Dressler EV, Ge Y, Melin SA, Gudena V, Lesser GJ. NEJM Evid. 2022 Sep;1(9):10.1056/evidoa2200097. doi: 10.1056/evidoa2200097. Epub 2022 Aug 18. PMID: 36908314
Longitudinal Right Ventricular Systolic Function Changes in Breast Cancer Patients Treated With Cardiotoxic Cancer Therapy.Demissei BG, Vedage NA, Hubbard RA, Smith AM, Chung J, Lefebvre B, Getz KD, Thavendiranathan P, Narayan HK, Ky B. JACC CardioOncol. 2022 Nov 15;4(4):552-554. doi: 10.1016/j.jaccao.2022.08.010. eCollection 2022 Nov. PMID: 36444221