Profiles in research: Bonnie Ky, M.D., M.S.C.E.

Bonnie KyBonnie Ky, M.D., M.S.C.E., aims to advance precision medicine in cardio-oncology, which is the study of cardiovascular disease in cancer patients. That’s important because even with more modern targeted cancer treatments, patients’ hearts and vascular systems often suffer.

Cardiotoxicity broadly defines cardiovascular injury that occurs with cancer therapies, according to Dr. Ky.

The goals are to have a deep understanding from using advanced imaging, biomarker tools and phenotyping which individual cancer patients are at high risk for cardiotoxicity, why they’re at risk and how to prevent the damage while delivering cancer treatment.

“Through the American Heart Association (AHA) Institute for Precision Cardiovascular Medicine, I’ve been fortunate to obtain funding for a project focusing specifically on using imaging to identify new patterns of cardiotoxicity in breast cancer patients,” said Dr. Ky, associate professor of Medicine and Epidemiology at Penn Medicine.

Dr. Ky and colleagues are using a large dataset of breast cancer patients with detailed echocardiography imaging done at multiple times before, during and after cancer treatment. The dataset also includes patients’ bloodwork and clinical information. Among the patients in the large data set are women who have had traditional chemotherapy and radiation, as well as highly specific cancer drugs, such as trastuzumab (Herceptin).

“These agents help breast cancer patients live longer. But they carry a notable risk of cardiotoxicity, including heart failure, in a growing cancer population of more than 15 million individuals worldwide,” she said .

Using the American Heart Association’s Precision Medicine Platform, Dr. Ky and colleagues are analyzing the echocardiograms with machine learning strategies, which means they’re harnessing technology and algorithms to detect patterns in imaging that might suggest cardiovascular damage or recovery in heart function. Computer learning technology can accelerate this type of research wit large and diverse datasets.

“Precision medicine will let us move past the one-size-fits-all strategy many providers use to treat cardiovascular patients today,” Dr. Ky said. “As a specialty, cancer has been doing it for a long time. We want to apply that same paradigm to cardiovascular disease using precision medicine.”

Cardiologists, oncologists and other providers will better understand how an individual patient’s biologic characteristics and genetic predispositions might put them at high risk of suffering from heart dysfunction or cardiotoxicity during or after cancer treatment. Providers can then take steps with a heart protective agent or other therapy to prevent the damage.

“It all comes down to the patient. Cardio-oncology is about advancing our understanding of cardiovascular disease to help patients get through their cancer treatment safely and help them live longer, high-quality lives,” Dr. Ky said.

“Part of precision medicine is not only looking at genetic variants, but also taken into account the gene and environment interactions that may also contribute to the risk for this disease.”

"We're looking to see if there’s a high incidence of certain genetic variants in stroke cases and have been able to tease out some genetic risks using our young-onset stroke model."

"Our project takes those two very large datasets and uses the AHA Precision Medicine Platform to accelerate findings of cardiovascular disease-related genetic causes."