Coronary plaque formation and progression in cancer survivors: longitudinal coronary CT angiography phenotyping across cardiotoxic therapies

About the research project

Background

Cardiovascular disease is an increasingly important determinant of long-term health in cancer survivors. Cancer and its treatments may accelerate atherosclerosis through inflammation, endothelial injury, oxidative stress and treatment-related metabolic changes. However, most cardio-oncology surveillance has focused on myocardial dysfunction, while the natural history of coronary atherosclerosis after cancer remains poorly defined. Coronary artery calcium (CAC) detects calcified disease but does not characterise non-calcified plaque, low-attenuation plaque or plaque transformation. coronary CT angiography (CCTA) therefore provides an opportunity to study not simply whether survivors have coronary disease, but how that disease forms and evolves over time.

Our recent work has shown that long-term cancer survivors have a greater CCTA-defined plaque burden, with the clearest difference observed in low-attenuation plaque. The critical unanswered question is whether this represents a static difference or a distinct disease trajectory. Serial CCTA across REDEEM-CAD, EDCAD and CAUGHT-CAD provides a unique platform to directly compare plaque progression in cancer survivors and non-cancer controls, while also investigating whether progression differs according to specific cancer therapies and exposure combinations.

Primary Hypotheses

1. Cancer survivors will demonstrate greater annualised progression of total and non-calcified coronary plaque than non-cancer controls, independent of baseline plaque burden, conventional cardiovascular risk factors and preventive treatment.
2. Coronary plaque trajectories will differ according to cancer treatment exposure, with cardiotoxic therapies and treatment combinations associated with distinct patterns of plaque composition, transformation and progression.
3. Baseline plaque phenotype and modifiable factors, including LDL cholesterol and statin treatment, will identify survivors at higher or lower risk of subsequent plaque progression.

SIGNIFICANCE AND EXPECTED OUTCOMES

This PhD will move beyond the observation that cancer survivors may have more coronary plaque and determine whether cancer changes the trajectory and biology of atherosclerosis. It will provide a direct longitudinal comparison with non-cancer controls, define treatment-specific plaque trajectories, and identify potentially modifiable determinants of progression. Expected outputs include evidence on cancer-associated plaque progression, treatment-specific vascular phenotypes, insight into the interaction between lipid lowering and cancer-related vascular risk, and a framework for identifying rapid progressors. These findings could support more personalised coronary surveillance and prevention in cardio-oncology and inform future imaging-guided prevention trials.

Primary supervisor

Meet Associate Professor Quan Huynh

Funding

Applicants will be considered for a Research Training Program (RTP) scholarship or Tasmania Graduate Research Scholarship (TGRS) which, if successful, provides:

• a living allowance stipend funded by University of Tasmania of $34,315 per annum for 3.5 years
• a tuition fees offset covering the cost of tuition fees for up to four years (domestic applicants only)

A tuition fee offset may be offered to eligible international applicants following competitive assessment 

As part of the application process you may indicate if you do not wish to be considered for scholarship funding.

Other funding opportunities and fees

For further information regarding other scholarships on offer, and the various fees for undertaking a research degree, please visit our Scholarships and fees on research degrees page.

Eligibility

Applicants should review the Higher Degree by Research minimum entry requirements.

Ensure your eligibility for the scholarship round by referring to our Key Dates.

Selection criteria

The project is competitively assessed and awarded. Selection is based on academic merit and suitability to the project as determined by the College.

Application process

1. Select your project, and check that you meet the eligibility and selection criteria, including citizenship;
2. Contact Associate Professor Quan Huynh to discuss your suitability and the project's requirements; and
3. In your application:
   • Copy and paste the title of the project from this advertisement into your application. If you don’t correctly do this your application may be rejected.
   • Submit a signed supervisory support form, a CV including contact details of 2 referees and your project research proposal.
4. Apply prior to 1 October 2026.

Full details of the application process can be found under the ' How to apply ' section of the Research Degrees website.

Following the closing date applications will be assessed within the College. Applicants should expect to receive notification of the outcome by email by the advertised outcome date.

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