Key result
New cardio-oncology surveillance framework dynamically tracks cardiovascular risk during cancer therapy.
Why the study?
Cardiovascular toxicity from diverse anticancer therapies converges on shared biological pathways, limiting static, therapy-specific surveillance approaches and underscoring the need for mechanism-informed, dynamic frameworks.
The COSS framework shifts cardio-oncology surveillance from rigid, therapy-specific protocols to a dynamic, mechanism-based approach to better capture and manage evolving cardiovascular risk.
May support dynamic cardio-oncology monitoring; leaves open whether COSS improves outcomes versus static protocols in prospective studies.
Contemporary anticancer therapies are increasingly diverse, yet cardiovascular toxicity (CVT) converges on shared myocardial, vascular, and immune–metabolic pathways. Variability in timing and reversibility limits static, therapy-specific surveillance and underscores the need for mechanism-informed approaches. This review introduces Cardio-Oncology Surveillance States (COSS), a conceptual, dynamic, mechanism-informed framework that characterises cardiovascular risk states across the cancer continuum. By integrating clinical phenotype, treatment exposure, multimodal imaging, biomarkers, and metabolic risk, COSS links biological pathways of injury to identifiable clinical signals and supports risk-adapted surveillance with escalation and de-escalation of monitoring intensity. By recognising bidirectional cancer–cardiovascular biology, this framework extends cardio-oncology beyond treatment-related toxicity and supports a prevention-oriented approach to long-term cardiovascular and oncologic outcomes.
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Lange et al. (2026) conducted a review in Cardiovascular toxicity across the cancer continuum. Cardio-Oncology Surveillance States (COSS) framework was evaluated. The review introduces Cardio-Oncology Surveillance States, a mechanism-informed framework that integrates clinical phenotype, imaging, and biomarkers to dynamically characterize cardiovascular risk during cancer therapy.
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