Key result
Cardio-oncology surveillance balances cancer therapy with cardiovascular safety, but high-quality evidence remains limited.
Why the study?
Implementation of cardio-oncology guidelines is hindered by limited, conflicting evidence, scarce dedicated services, and underdeveloped training programs, while cardiotoxicity risk stratification tools require further validation.
Multidisciplinary cardio-oncology care, including risk stratification and surveillance, is essential to balance cancer therapy efficacy with cardiovascular safety, though widespread implementation of current guidelines remains challenging.
Warrants routine cardio-oncology involvement in high-risk cancer therapy; leaves open scalable strategies to overcome guideline implementation barriers.
Cardio-oncology is a rapidly developing subspecialty addressing the growing burden of cardiovascular disease (CVD) in cancer patients exposed to cardiotoxic therapies.Since the creation of the European Society of Cardiology (ESC) Council of Cardio-Oncology in 2018, the field has advanced significantly, with the 2022 ESC Cardio-Oncology Guidelines and the 2024 ESC Core Curriculum defining standards of care and specialist training.Multidisciplinary collaboration remains central, integrating expertise from cardiology, oncology, hematology, and radiology.Breast cancer illustrates the challenges of survivorship, as long-term outcomes are increasingly limited by CVD.Anthracyclines, human epidermal growth factor receptor (HER) 2-targeted agents, immune checkpoint inhibitors, and radiotherapy contribute to diverse cardiotoxicities, including heart failure, arrhythmias, and vascular disease.Risk stratification tools, biomarkers, and imaging enable early detection, but further validation across patient populations is required.The ESC guidelines recommend structured assessment, surveillance, and preventive strategies, yet widespread implementation is hindered by limited high-quality and sometimes conflicting evidence, scarce dedicated services, and underdeveloped training programs.Similar challenges are evident in malignant hematology, where Bruton tyrosine kinase inhibitors carry significant cardiovascular risks.Overall, cardio-oncology emphasizes balancing effective cancer therapy with cardiovascular safety.Continued research, interdisciplinary collaboration, and dedicated care models are essential to improving long-term outcomes in this complex patient population.
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Gulati et al. (2025) conducted a review in Cardiovascular disease in cancer patients. Cardio-oncology guidelines recommend structured assessment and surveillance to balance cancer therapy with cardiovascular safety, though implementation is hindered by limited high-quality evidence.
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