In the evolving landscape of pediatric oncology, survivorship research has become an essential component of our mission to improve long-term patient outcomes. At City of Hope, we are focused on not only curing childhood cancers but also ensuring that survivors live the healthiest lives possible. A significant part of my research has been dedicated to mitigating the long-term toxicities of cancer therapy—particularly cardiovascular complications that can arise decades after treatment.
The intersection of cancer and cardiology
A major area of investigation in our work has been the field of cardio-oncology, which has grown in prominence as cancer treatments continue to extend lives. While chemotherapy and radiation have significantly improved survival rates, they also introduce cardiovascular risks that can shorten those very lives we strive to save. The question we have sought to answer is: How do we prevent these complications before they become irreversible?
Our research has shown that cancer survivors face an accelerated aging process that predisposes them to cardiovascular disease at much higher rates than the general population. This has led to interventions such as the use of beta-blockers like carvedilol in randomized clinical trials to protect cardiac function in patients at high risk. We have also explored the role of clonal hematopoiesis of indeterminate potential (CHIP), a biomarker that may predict long-term cardiovascular risk in cancer survivors. These findings have begun to reshape how we monitor and intervene in survivorship care.
A shift toward precision medicine
As we move forward, the integration of precision medicine in pediatric oncology is essential. The traditional treatment paradigms—relying heavily on broad-spectrum chemotherapies and radiation—must give way to targeted therapies that minimize long-term toxicities. Immunotherapy, for instance, is rapidly transforming the way we approach pediatric malignancies, offering the promise of sustained remission without the collateral damage of conventional treatments.
A key goal for the future is de-escalating therapy where possible, ensuring that children receive the most effective treatment with the fewest long-term consequences. This requires robust clinical trials that can balance the urgency of treating aggressive cancers with the need to preserve a patient’s long-term health.
The future of survivorship research
At City of Hope, we are developing new models of care that address not just the immediate disease but the lifelong health trajectory of our patients. With the expansion of our national footprint, we have the opportunity to study diverse populations and improve survivorship strategies across different demographics. The vision is clear: Survivorship care must evolve from reactive management of late effects to proactive prevention strategies.
City of Hope has always been at the forefront of groundbreaking research, from the development of bone marrow transplantation to advancements in immunotherapy. Now, the next frontier is ensuring that a cancer cure is synonymous with a healthy, full life. That is the ultimate measure of success in pediatric oncology, and it remains my driving mission.
Listen to Dr. Armenian on City of Hope’s new podcast, “On the Edge of Breakthrough: Voices of Cancer Research.” Available on Spotify, Apple Podcasts and at cityofhope.org/edge-of-breakthrough.
City of Hope®, one of the largest and most advanced cancer research and treatment organizations in the U.S. with its National Medical Center named top 5 in the nation for cancer by U.S. News & World Report. To learn more about City of Hope, visit: www.cityofhope.org.
