Pediatric Cardio-Oncology Focus of Global Conference

Scheduled for Oct. 21-22 in Cincinnati, the conference is expected to attract 300 to 500 global health professionals to discuss the latest developments in the rapidly emerging subspecialty of pediatric cardio-oncology.

The conference is jointly sponsored by Sofia’s Hope, the Cardio-Oncology Program at Cincinnati Children’s Hospital Medical Center (CCHMC), the Department of Pediatrics at the Jacobs School of Medicine and Biomedical Sciences and Oishei Children’s Hospital.

Sofia’s Hope is a nonprofit organization founded by the family of Sofia Blanco, a former childhood cancer patient of Lipshultz who died of heart failure at the age of 13.

Sofia was 4 years old when she was diagnosed with an extremely aggressive form of non-Hodgkin lymphoma.

She underwent a year of chemotherapy, but eight months into her treatment she developed heart failure that was initially thought to be viral. Unfortunately, it was actually caused by one of the chemotherapy drugs (the anthracycline Adriamyacin) used in her protocol, according to her mother, Marta Blanco. 

“We were told by the head of the hospital’s cardiac intensive care unit that Sofia needed a heart transplant, but would not qualify for one, and that there was nothing more they could do,” she says.

It was then that Marta and her husband, Carlos, learned of Lipshultz, who was chair of pediatrics and an executive dean of the University of Miami Miller School of Medicine.

They reached out to him and he recommended a treatment plan that the Blancos insisted the hospital follow.

From then on, Sofia enjoyed a pretty good quality of life for several years, but would occasionally need to be admitted to the hospital if she got sick or got a cold.

She died a month after her 13^th birthday of heart failure, while she was in a pediatric intensive care unit awaiting a heart transplant, according to her mother.

“Sofia got those eight extra years of life because of Dr. Lipshultz — because of the treatment that he gave her,” Marta Blanco says.

Lipshultz says Sofia’s parents never wanted to forget, so they created Sofia’s Hope to raise money dedicated to finding cures for childhood cancer.

Since Lipshultz came to UB, Kathy M. Swenson, senior director of advancement, has worked closely with the Blancos and the family has supported UB and Jacobs School research in cardio-oncology.

“One of the things I suggested to the board of Sofia’s Hope is to help fund an international pediatric cardio-oncology conference,” he says. “I said to Sofia’s family that I appreciate very much that they donate money to UB to help support our own personal work in cardio-oncology.”

“But I also told them we have the opportunity to bring together cardiologists, oncologists, nurses, families and others through an exchange of ideas, disseminating information and getting to having a higher standard of care for these patients who in some cases, like Sofia, developed heart problems during therapy.”

Marta Blanco says what happened to Sofia should not have happened and “we need to prevent other Sofias from happening.”

“The best way to do that is to get information out worldwide because there are treatments and better ways to diagnose earlier,” she says. “The conference is like a bullhorn to get that information out to as many people as possible.”

“I advocated for Sofia all along the way and I am still advocating for her by doing this, supporting Dr. Lipshultz’ work and trying to get the word out and that is why this conference means everything to me,” Marta Blanco adds.

In early 2019 during a meeting for experts in pediatric heart failure, Thomas D. Ryan, MD, PhD, a cardiologist at CCHMC, approached Lipshultz to discuss establishing a meeting to focus on the cardiovascular disease experienced by pediatric patients with cancer. 

“Anyone in the field of pediatric cardio-oncology knows the work of Dr. Lipshultz, who is a pioneer in the field. With the support of the leadership of the Heart Institute at CCHMC I was just beginning to organize a meeting for pediatric cardio-oncology,” Ryan says.

“When I asked Dr. Lipshultz for his thoughts, he told me about Sofia’s Hope and his desire to do the same. He suggested we combine our efforts and I couldn’t believe the opportunity in front of me.” 

With Sofia’s Hope on board as well as financial support from CCHMC,  Lipshultz and Ryan formed an international steering committee in 2019 with plans to host the meeting in fall 2020. 

The conference’s steering committee includes two additional UB faculty members:

• Javier G. Blanco, PhD, professor of pharmaceutical sciences in the UB School of Pharmacy and Pharmaceutical Sciences, where he is an expert in genetic and epigenetic factors that contribute to childhood cancer chemotherapeutic cardiotoxicity
• Umesh Sharma, MD, PhD, associate professor of medicine, where he is a cardiologist with expertise in the cardiotoxicity of radiation therapy
  

“I determined that in order to do this right we needed even more resources financially because we really wanted a face-to-face meeting so we could promote the dialogue and exchange of ideas — things that are harder to do in a virtual meeting,” Lipshultz says.

Toward that end, CCHMC agreed to fund a significant part of the meeting, as well as commit the time of several members of the Heart Institute business and education teams for organizing the meeting working along with key staff members at UB, including Miriam Alexandra Mestre, senior research support specialist in the Department of Pediatrics.

“It has been a great partnership,” Lipshultz says. “We have scheduled this meeting twice in Cincinnati, but had to cancel due to COVID-19. But now we are 100 percent on track for the meeting this fall.”

Lipshultz says he is very excited about the conference because “the Jacobs School is helping to lead the world in this area.”

He says the conference is a way to have an exchange of information among scholars.

“It is carefully curated and the most important topics have been put together in regular monthly meetings by the experts in the world in this area over the last three years,” Lipshultz says.

“The goal is that people will learn from each other, the important topics will be covered, the important questions will be raised and future directions of where this field should be going if we are going to have the greatest impact on children should be established.”

“The Jacobs School is proud to be a sponsor of the first international pediatric cardio-oncology conference,” says Allison Brashear, MD, MBA, UB’s vice president for health sciences and dean of the Jacobs School. “I am excited that Dr. Lipshultz is leading this global educational outreach on a subject that is tremendously important to many families of childhood cancer patients.”

Lipshultz says “pediatric oncology is one of the biggest miracles in pediatric medicine in the last 50 years.”

“In 1969, for example, if you had a child diagnosed with leukemia, the most common type of childhood cancer, five years after diagnosis, only 4 percent of all those children were disease free, which meant they were cured,” he says.

“Right now, for that same childhood leukemia patient, through the best protocols that we use, it is 91 percent of the children are alive and cured of their leukemia five years after diagnosis,” Lipshultz says. “It’s almost the best outcome change we have seen in pediatric medicine.”

It is estimated about one in every 500 young adults in the U.S. aged 20-to-45 years is currently a survivor of childhood cancer.

“Their quality of life over their lifetime becomes something we can focus on rather than just the cure rate for cancer,” he says. “If they get so much damage to their heart in the process of getting cured and they are living with congestive heart failure, their quality of life may be terrible.”

“That’s what we are trying to do. The best outcome is not just to cure cancer. It’s the balance between oncologic efficacy and delayed effects and toxicities of the treatments for cancer,” Lipshultz says.

“One thing my colleagues and I discovered was a medicine called dexrazoxane that is now used all over the world. It protects from the damaging effects to the heart of one of the most commonly used chemotherapies for children,” he says.

“For that one type of chemotherapy, it effectively protects the heart and it doesn’t interfere with curing the cancer,” Lipshultz says. “That’s cool. That’s the result of 30 years of dedicated work by our team.”

National Institutes of Health (NIH) experts will also conduct a session at the conference because they recognize the importance and fund most of the research in this area, Lipshultz says.

“This helps align what type of work the NIH should be focusing on based on the science that we will be presenting at the meeting,” he adds. “Moving forward, this not only helps to lead to better care by the providers, but it also helps the funding sources determine where the greatest needs are and what priorities they should be funding.”

About eight years ago, Lipshultz and his colleagues created the first journal in the world for doctors of cardio-oncology. It is called Cardio-Oncology and is published by Springer Nature, one of the world's leading global research, educational and professional publishers.

Lipshultz is editor-in-chief and Mestre is the journal’s managing editor. The journal’s editorial office is based at UB.

“It became the very first journal in the world to be indexed in the field of cardio-oncology,” he says. “One of the reasons we did this is to have other doctors understand the unique issues to the heart and blood vessels that cancer patients have.”

Lipshultz says the leading parts of the meeting will be published in the Cardio-Oncology journal.

“If you have a meeting with 300 to 500 people, then you are only reaching 300 to 500 people,” he says. “If you work so hard to get the very best and brightest assembled together, you want to disseminate information more broadly.”

“Springer has felt this is so important that they have waived publication costs,” Lipshultz says. “The most important elements of the meeting will be published for free so that it gets out to anyone in the world who cares about this area of medicine.”

“Hopefully, that leads to not just dissemination, but implementation.”