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Radiomic-based Integrated Cancer Treatment Benefit and Cardiovascular Outcome Risk (RICTOR scale)

Award Number: R01HL189500
ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)
PERIOD OF PERFORMANCE START DATE: 08/10/2026
PERIOD OF PERFORMANCE END DATE: 05/31/2030

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Radiomic-based Integrated Cancer Treatment Benefit and Cardiovascular Outcome Risk (RICTOR scale) - ` PROJECT SUMMARY: Approximately 225,000 new lung cancers are diagnosed annually in the United States. Patients with lung cancer are at markedly elevated risk for cardiovascular disease (CVD) related events and mortality, owing to shared risk factors between CVD and cancer, and the cardiotoxic effects of therapies such as anthracyclines, immunotherapy (IT), and radiation. The annual incidence of major adverse cardiovascular events (MACE) in these patients is estimated between 5% and 10%. Although multidisciplinary medical society statements recommend baseline CVD risk assessment in patients diagnosed with cancer before initiation of cardiotoxic medications. However, validated and pragmatic tools for cardiovascular risk evaluation in this population are lacking. Additionally, response to cancer therapies, particularly immunotherapies, is heterogeneous and should be balanced against the risk of non-cancer specific adverse outcomes, particularly MACE. Accordingly, there is an unmet need for integrated, cardio-oncology decision-support tools that combine prediction of CVD risk and treatment benefit to facilitate personalized care. To address this need, we aim to develop, optimize and validate a Radiomic-based Integrated Cancer Treatment Benefit and Cardiovascular Outcome Risk (RICTOR) scale to characterize IT benefit and MACE risk concurrently. It will provide clinically meaningful and actionable information to facilitate shared decision making, guide pre-emptive cardioprotective strategies, and inform surveillance and prevention of MACE. This novel integrated cardiology-oncology score (RICTOR) will help identify patients who can benefit most (i.e., responders to cancer therapies) without a concomitant increase in cardiovascular risk (i.e., low MACE risk). The underlying scientific premise of this study is that a machine-learning-based score (RICTOR) combining clinical parameters with AI-facilitated chest CT–derived: (1) cardio-metabolic risk radiomics (CMR: e.g., coronary and vascular calcification, chamber and great vessel size, and adipose volume), (2) tumor radiomics (TMR: novel tumoral/peri- tumoral texture and vascularity), and (3) Social and Environmental Determinants of Health (SEDH) linked through residential address will allow for improved prediction of both CVD and cancer-related outcomes, providing actionable information to facilitate shared decision making and therapeutic planning. Our ongoing multi-year, multi-center collaborations have demonstrated the utility of explainable AI methods to extract CT-derived CMR and TMR features that predict cardiovascular risk and benefit of cancer therapies. We will build upon these data and leverage CT scans from >6,000 cancer patients previously treated with IT from our institutional and pharma partners to optimize and validate RICTOR in non-small cell lung carcinoma (NSCLC). Successful project completion will not only result in a validated RICTOR model for NSCLC patients but also set the stage for evaluating RICTOR for other diseases and treatment modalities.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2026 ( Subtotal = $788,336 )
2026	2026	EMORY UNIVERSITY	201 DOWMAN DR NE	ATLANTA	GA	30322	DEKALB	USA	Cardiovascular Diseases Research	000	1	8/10/2026	NEW	$788,336
														Subtotal = $788,336

Grand Total All Awards = $788,336

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Radiomic-based Integrated Cancer Treatment Benefit and Cardiovascular Outcome Risk (RICTOR scale)

Award Number: R01HL189500

ORGANIZATION: NATIONAL HEART, LUNG, & BLOOD INSTITUTE

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: SCIENTIFIC/HEALTH RESEARCH (INCLUDES SURVEYS)

PERIOD OF PERFORMANCE START DATE: 08/10/2026

PERIOD OF PERFORMANCE END DATE: 05/31/2030

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