VO2peak is standard for cardiology, just not oncology. Cardio-oncology is a very new subspecialty in medicine and not many oncologists are aware that drugs like doxorubicin affect more than just the heart. The good news is the division of the FDA we will need to deal with (cardiology) is very aware of VO2peak.
None of the oncologists we are bringing on as sites have any issue with using VO2peak (we have really probed this after the PET issue with EMD AML). Erin and her team at the Baker Institute also had no problem getting oncologists to take part in her VO2peak studies and she had nothing really to offer the patients other than exercise.
The PET issue with EMD AML was more subtle than the haematologists dismissing it - they were all very supportive of using PET to diagnose EMD AML, the issue was one of them not being willing to do non-standard of care imaging (PET) while the patients were responding to standard of care (SOC) treatment. We had solved this problem by removing the need for upfront PET scanning in the EMD AML trial (basically we planned to allow anyone in with AML that have failed all SOC treatment and then perform the PET scan), but before this change to the protocol could be implemented, the trial was cancelled by the management at the time. I will leave you guys to decide is this cancellation was wise or not.
In the current cardioprotection trial all of the patients will have failed all conventional treatment so none of the SOC blocks to doing something experimental like VO2peak apply.
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