Chemotherapy can be a lifesaver for an individual fighting cancer, but certain cancer treatments can put a person’s heart at risk. UTEP u
Cardiac toxicity, or heart damage, is a serious side effect of many conventional chemotherapy drugs used to treat cancer. Chemotherapy can kill or damage healthy cells in the body, not just the cancerous ones, resulting in cardiomyopathy, arrhythmia or heart failure.
“There are more than 100 FDA-approved anticancer drugs on the market, but many of these drugs can result in cardiac toxicity,” said Md Nurunnabi, Ph.D., assistant professor of pharmaceutical sciences at The University of Texas at El Paso’s School of Pharmacy. “Chemotherapy can affect many organs, but the heart is the most critical organ because heart-cell regeneration is much more complicated. It is more difficult for the heart to repair acute damage caused by severe toxicity.”
According to Nurunnabi, cardiac toxicity is often irreversible and can affect a patient’s quality of life even after they have recovered from cancer.
Although medical imaging procedures such as MRI may be safely used to monitor the heart during cancer treatment, early detection of cardiac toxicity is not feasible through current methods.
But change is on the horizon at UTEP. Nurunnabi and Humayra Afrin, a graduate research assistant at the Nurunnabi Lab, have developed an injectable imaging nanoprobe that could be used in real time to measure toxicity in the hearts of patients undergoing cancer treatment.
The diagnostic nanoprobe can detect a biomarker that indicates damaged cells within the heart muscle.
Similar to a glucometer, Nurunnabi plans to create a rapid and low-cost point-of-care testing device that could be used by oncologists to monitor the intensity of cardiac toxicity in the cardiac muscle cells using a small amount of blood.
Nurunnabi, an expert in biomaterials, biomedical imaging and bioengineering, said physicians would be able to measure the level of cardiac damage as anticancer drugs are being administered. Results could be used to make real-time decisions about a patient’s cancer treatment, including adjusting the dosage and frequency of the anticancer drug before chronic cardiac dysfunction occurs.
“If we can protect the healthy cell from the toxic effect of the anticancer drug, we would be able to improve cancer treatment significantly by saving millions of lives utilizing the existing FDA approved anticancer drug,” said Nurunnabi, whose research is being funded by the Lizanell and Colbert Coldwell Foundation.
“In order to develop such advanced delivery systems, we will have to know which and how many non-cancerous cells these drugs are killing,” Nurunnabi said.
Afrin, a student in UTEP’s Environmental Science and Engineering doctoral program, completed her residency in oncology after finishing her studies at Rangpur Medical College in Rangpur, Bangladesh. She received her Bachelor of Medicine, Bachelor of Surgery (MBBS) degree in 2011.
Afrin said she saw firsthand how chemotherapy can adversely affect people with cancer, and how important it was for doctors to detect cardiac toxicity in its early stages.
“The current available methods for detection are invasive and costly,” Afrin said. “Also, it mostly remains asymptomatic until the later stage when the damage is irreversible. Around 37% of cancer patients die because of heart failure as a side effect of chemotherapy. If we screen every patient receiving anticancer treatment/chemotherapy with our imaging nanoprobe to detect the cardiac damage early, it will save a lot of lives.”
Marc Cox, Ph.D., chair of UTEP’s Pharmaceutical Sciences Department, said Nurunnabi’s research would help meet the critical need for diagnostic technologies to identify and mitigate the short- and long-term cardiac effects that result from cardiotoxicity.
“Dr. Nurunnabi is working to address this major unmet need, and the technology he is developing will allow clinicians to monitor the cardiac heath in real-time and non-invasively during chemotherapy,” Cox said. “Monitoring of cardiac damage due to side effects of chemotherapeutics will inform changes in treatment strategies to minimize cardiac damage and will improve overall quality of life for cancer patients.”
Nurunnabi and his team are currently conducting preclinical trials to validate and optimize the efficacy of the nanoprobe. In the future, he plans to collaborate with physicians to validate and optimize his tool using patient samples in clinical trials.
In the meantime, Tamanna Islam, a doctoral student in UTEP’s Environmental Science and Engineering program and one of Nurunnabi’s research assistants, is applying her background in chemistry to develop a highly sensitive point-of-care biosensor that can detect even the smallest amount of cardiotoxicity from drops of blood.
Islam said current diagnosis methods require complicated equipment and skilled professionals to perform the testing. But with UTEP’s point-of-care technology, testing could be performed while patients undergo chemotherapy in a clinic by the clinic’s staff. Also, because the device is highly sensitive, it would be able to detect early stages of cardiac toxicity before symptoms appear.
Working in Nurunnabi’s lab has been an opportunity for Islam to hone her research skills on projects that will have a positive impact on society.
“My long-term goal is to be a good researcher, but at the same time, I want to make sure that I’m learning as much as possible, which matters to me the most,” said Islam, who came to UTEP in spring 2021. “I would like to implement and apply all those things that I have learned working in different projects and have our findings published for others to know about our work.”