Charting the Current Landscape and Future Prospects of Cancer Therapy-Related Cardiovascular Toxicity in Cancer Survivors: From Bench to Bedside

Cardio-oncology represents an emerging interdisciplinary discipline focusing on optimizing oncologic efficacy while mitigating treatment-related cardiovascular complications. The advent of novel anticancer agents such as targeted therapies, immune checkpoint inhibitors, and endocrine therapies has transformed cancer care, significantly improving survival rates. Nevertheless, prolonged patient survivorship has unmasked clinically significant cardiovascular sequelae, termed cancer therapy-related cardiovascular toxicity (CTR-CVT), which manifests as acute manifestations during therapy and delayed presentations persisting years post-treatment. This dual-onset toxicity profile necessitates rigorous longitudinal cardiovascular risk stratification integrating comprehensive pre-therapeutic assessment, multi-modal imaging, and biomarker-guided surveillance to detect subclinical dysfunction, prevent premature treatment cessation, and reduce cancer recurrence and mortality risks. Future research priorities include further elucidating pathophysiological mechanisms of CTR-CVT, developing cardio-protective strategies, implementing personalized therapeutic protocols, and reducing disparities in care to advance cardio-oncology and improve patient outcomes. This review synthesizes the development of CTR-CVT, existing evidence-based CTR-CVT risk surveillance approaches, and emerging innovative early-warning strategies, and the future development prospects.