Browsing by Author "Yang, Eric H."

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    Advances in Multimodality Imaging in Cardio-Oncology: JACC State-of-the-Art Review
    (Elsevier, 2022-10-18) Baldassarre, Lauren A.; Ganatra, Sarju; Lopez-Mattei, Juan; Yang, Eric H.; Zaha, Vlad G.; Wong, Timothy C.; Ayoub, Chadi; DeCara, Jeanne M.; Dent, Susan; Deswal, Anita; Ghosh, Arjun K.; Henry, Mariana; Khemka, Abhishek; Leja, Monika; Rudski, Lawrence; Villarraga, Hector R.; Liu, Jennifer E.; Barac, Ana; Scherrer-Crosbie, Marielle; ACC Cardio-Oncology and the ACC Imaging Councils; Medicine, School of Medicine
    The population of patients with cancer is rapidly expanding, and the diagnosis and monitoring of cardiovascular complications greatly rely on imaging. Numerous advances in the field of cardio-oncology and imaging have occurred in recent years. This review presents updated and practical approaches for multimodality cardiovascular imaging in the cardio-oncology patient and provides recommendations for imaging to detect the myriad of adverse cardiovascular effects associated with antineoplastic therapy, such as cardiomyopathy, atherosclerosis, vascular toxicity, myocarditis, valve disease, and cardiac masses. Uniquely, we address the role of cardiovascular imaging in patients with pre-existing cardiomyopathy, pregnant patients, long-term survivors, and populations with limited resources. We also address future avenues of investigation and opportunities for artificial intelligence applications in cardio-oncology imaging. This review provides a uniform practical approach to cardiovascular imaging for patients with cancer.
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    Safety and efficacy of immune checkpoint therapy for the treatment of patients with cardiac metastasis: a multicenter international retrospective study
    (BMJ, 2025-03-03) Nassar, Amin H.; Abou Alaiwi, Sarah; El Zarif, Talal; Denu, Ryan; Macaron, Walid; Abdel-Wahab, Noha; Freeman, Dory; Vasbinder, Alexi; Hayeck, Salim; Anderson, Elizabeth; Goodman, Rachel S.; Johnson, Douglas B.; Grynberg, Shirly; Shapira, Ronnie; Kwan, Jennifer M.; Woodford, Rachel; Long, Georgina V.; Haykal, Tarek; Dent, Susan; Kojima, Yuki; Yonemor, Kan; Tandon, Ankita; Trevino, Alexandra; Akhter, Nausheen; Yang, Eric H.; Hui, Gavin; Drakaki, Alexandra; El-Am, Edward; Kozaily, Elie; Al-Hader, Ahmad; Farhat, Elias Bou; Babu, Priyanka; Mittra, Arjun; Li, Mingjia; Jones, Nicholas; Baena, Javier; Juarez Herrera, Mercedes; Foderaro, Simone; Aboubakar Nana, Frank; Kim, Chul; Sackstein, Paul; Parikh, Kaushal; Desai, Aakash P.; Smith, Caleb; Cortellini, Alessio; Pinato, David J.; Korolewicz, James; Lopetegui-Lia, Nerea; Funchain, Pauline; Choudhary, Arrush; Asnani, Aarti; Navani, Vishal; Meyers, Daniel; Stukalin, Igor; Ocejo Gallegos, Jesus Antonio; Trent, Jonathan; Nusrat, Sanober; Malvar, Carmel; McKay, Rana R.; Neilan, Tomas G.; Choueiri, Toni K.; Naqash, Abdul Rafeh; Medicine, School of Medicine
    Background: Data on the safety profiles and clinical outcomes of patients with solid tumors and cardiac metastasis treated with immune checkpoint inhibitors (ICIs) are limited. Methods: This is an international multicenter retrospective study of patients with cancer and cardiac metastasis at baseline. Patients who had received ≥1 dose of ICI were included. Treatment-related adverse events (trAEs) were graded per Common Terminology Criteria for Adverse Event V.5.0. Objective response rates (ORR) were evaluated by Response Evaluation Criteria in Solid Tumors V.1.1 when available. Overall survival (OS) and progression-free survival (PFS) were estimated by the Kaplan-Meier method. Results: Among 110 pts, median age at ICI initiation was 65 (IQR: 59-75). Median follow-up time since ICI initiation was 36 (95% CI: 26 to 51) months. Melanoma (38%, n=42) and non-small cell lung cancer (24%, n=26) were the most common. 68 (62%) patients received ICIs as first-line, and 29 (26%) patients were treated with combination anti-programmed death-1 and anti-cytotoxic T-lymphocyte antigen 4. The most common location of cardiac metastasis was in the atria (37%, n=41) and ventricles (35%, n=39). 15 patients (13.6%) had bilateral cardiac/pericardial metastasis, 44 (40%) had left-sided, and 43 (39.8%) had right-sided. At ICI initiation, 21% (n=23) had a cardiac thrombus. Cardiology referrals and cardiac MRIs at the time of cancer diagnosis were completed on 58 (53%) and 52 (47%) patients, respectively. Cardiac events occurred in 40 (36%) patients, including arrhythmias (n=14, 13%), arterial/venous emboli (n=4, 3.6%), and cardiac tamponade (n=3, 2.7%). 53 (47%) patients developed trAEs; most common were colitis/diarrhea (n=16, 15%), dermatitis (n=13, 12%), and hepatitis (n=9, 8.2%). ICI-related major cardiac trAEs occurred in 2 (1.8%) patients. 22 patients (20%) developed grade ≥3 trAE. Patients with multiple cardiac metastases had significantly lower responses to ICI-based regimens compared with patients with single cardiac metastasis (11% vs 63%, p=0.02). For melanoma, ORR, median PFS, and median OS were 38%, 9.0 months, and 28.9 months, respectively. 83% of patients with melanoma had concordant responses in overall disease burden and cardiac disease. 91 patients discontinued ICIs, and the main reason was progression or death in 55 (49%) patients. Conclusions: Among patients with pre-existing cardiac metastasis, ICIs demonstrated meaningful clinical efficacy with no increase in safety signals. Most patients had concordant responses in the overall disease burden and cardiac mass. Multidisciplinary teams are crucial for the appropriate management of patients with cardiac metastasis.