Javid Moslehi, MD, has been named section chief of the new Cardio-Oncology & Immunology Program at UC San Francisco, which brings together cardiologists, oncologists, immunologists and researchers to promote the cardiovascular health of patients during cancer treatment and survivorship. The program offers treatment for specific cardio-oncology conditions, including amyloidosis, carcinoid heart disease, myocarditis and clonal hematopoiesis of indeterminate potential (CHIP).
Moslehi comes to UCSF from Vanderbilt University Medical Center where he was director of the Cardio-Oncology Program and co-director of the Vanderbilt Program for Optimizing Immuno-Oncology Therapy. He completed his residency at the Johns Hopkins Hospital, followed by a cardiology fellowship at Brigham and Women's Hospital and a postdoctoral research fellowship at the Dana-Farber Cancer Institute.
In his basic research, Moslehi examines the mechanisms of cardiovascular and cardiometabolic complications associated with targeted cancer therapies. In this interview, he talks about the emerging field of cardio-oncology, clinical applications of his research and UCSF’s culture of collaboration.
Q: Why is cardio-oncology growing as a discipline?
A: Cardio-oncology has emerged as a new clinical discipline because of the success our oncology colleagues have had in treating cancer. There are now approximately 18 million Americans who are cancer survivors, which was unimaginable 10 years ago. Unfortunately, many oncology therapies can adversely affect the heart. We initially observed this in breast cancer, where traditional therapies like anthracyclines and radiation as well as new therapies such as trastuzumab can increase the patient’s risk of heart disease.
More recently, immunotherapies have revolutionized treatment for cancer, but some patients have acute or chronic inflammatory heart problems, such as myocarditis. As cardio-oncologists, we need to monitor patients’ heart function during treatment so they can continue therapy as safely as possible. We are also trying to understand whether immunotherapies can have long-term complications.
Q: Why is UCSF the right place for this new Cardio-Oncology & Immunology Program?
A: UCSF is a premier medical center and what makes it unique is the culture of collaboration. For example, the Bakar ImmunoX Initiative is the flagship and one of the best immunology programs in the world. I’m excited to be involved in this initiative and to use the resources to shape our new section. I also see cardio-oncology as a new platform for investigation and am very interested in training the next generation of physician-scientists in this field.
Q: Can you describe how your research has helped patients?
A: At Vanderbilt, in a study a few years ago, we found that some patients developed sudden myocarditis after treatment with immune checkpoint inhibitors (ICIs). To understand this clinical syndrome, we created an international registry with a lot of cases from around the world. This international team that we have led has produced a consensus statement about how to best care for patients and has described the arrhythmogenic nature of ICI-myocarditis in a recent research letter published in Circulation. We had also established a basic and translational research group and developed a mouse model to understand the syndrome mechanistically. We discovered that abatacept, a rheumatoid arthritis drug, successfully treated the mice and are now using it to reduce inflammation in patients who have developed ICI-related myocarditis.
Q: What makes the UCSF cardio-oncology program unique?
A: Our ability to bridge basic and translational research with clinical excellence. We are also defining some of the new frontiers in the field – for example, how new revolutionary immunotherapies affect the heart. We are also assessing new drugs that target tumor metabolism and the impact of these metabolic changes on the cardiovascular system. By bringing researchers and clinical groups together, we hope to advance the field and better care for our patients.
Q: In one of your New England Journal of Medicine articles, you wrote that cardio-oncology “extends beyond toxicology.” What did you mean by that?
A: We have new appreciation for the intersection of cardiovascular diseases and cancer. For example, we now recognize that common risk factors can predispose people to both heart disease and cancer. We knew this with smoking but we now know there are other common risk factors, including hyperlipidemia, obesity and CHIP. A better understanding of why there are such common risk factors to both heart disease and cancer has enormous implications for the growing number of cancer survivors.
Q: How does the UCSF Cardio-Oncology & Immunology Program collaborate with referring physicians?
A: In addition to me, there are two other physicians, Drs. Mandar Aras and Alan Baik. We work as a team. We see patients here and then we work with referring cardiologists or oncologists to help travel the path of when to give the cancer treatment and when to monitor the heart. It is a team effort.
All cancer research and treatment at UCSF takes place within the UCSF Helen Diller Family Comprehensive Cancer Centerwhere Moslehi is an integral member.
UCSF Medical Center is recognized as best in Northern California for cancer care by U.S. News & World Report’s 2021-2022 Best Hospitals survey.
To learn more
Cardio-Oncology & Immunology Program
Phone: (415) 353-2873 | Fax: (415) 353-2528