Charting the Current Landscape and Future Prospects of Cancer Therapy-Related Cardiovascular Toxicity in Cancer Survivors - Review

Sep 23, 2026

Uploaded by Rowan

Cardio-oncology represents an emerging interdisciplinary discipline focusing on optimizing oncologic efficacy while mitigating treatment-related cardiovascular complications. Novel anticancer agents such as targeted therapies, immune checkpoint inhibitors, and endocrine therapies have improved survival, yet prolonged survivorship reveals cancer therapy-related cardiovascular toxicity (CTR-CVT). CTR-CVT includes acute treatment-phase events and delayed sequelae persisting years after therapy, requiring rigorous longitudinal cardiovascular risk stratification. Pre-therapeutic assessment, multi-modal imaging, and biomarker-guided surveillance support subclinical detection, reduce premature treatment cessation, and lower recurrence and mortality risks. Future work aims to clarify mechanisms, develop cardio-protective strategies, implement personalized protocols, and narrow care disparities.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages19

Reading Time48 min

AccessFree to download

Introduction

Cardio-oncology and the CTR-CVT problem

Coverage of CTR-CVT manifestations and burden

Guidelines and consensus milestones

Drug Design, Development and Therapy Open Access Full Text Article REVIEW Charting the Current Landscape and Future Prospects of Cancer Therapy-Related Cardiovascular Toxicity in Cancer Survivors: From Bench to Bedside Shiyi Tao 1 , Lintong Yu2 , Lanxin Zhang 3 , Jun Li 1 , Ji Wu 1 , Yuqing Tan 1 1Department of Cardiology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People’s Republic of China; 2Graduate school, Beijing University of Chinese Medicine, Beijing, 100029, People’s Republic of China; 3Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, People’s Republic of China Correspondence: Jun Li, [Email gamyylj@163.com](Email gamyylj@163.com) | Abstract: 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 ofCTR-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.
Keywords: cancer therapy-related cardiovascular toxicity, cardio-oncology, cardiotoxicity, prevention, monitoring | | --- | | Introduction
Cardiovascular diseases (CVD) and cancer are the two leading chronic diseases responsible for global mortality.1 With the advancement of cancer treatment modalities, including chemotherapy, radiation therapy, targeted therapy, and immunotherapy, the survival rate of cancer patients has significantly improved.2 However, the long-term use of these therapies poses serious risks of cancer therapy-related cardiovascular toxicity (CTR-CVT), which have become a major challenge in the field of oncology.3 Cardio-oncology, an emerging interdisciplinary field combining oncology and cardiology (Figure 1), focuses on studying the cardiovascular complications caused by cancer therapies, the impact of cardiovascular diseases on cancer treatment and prognosis, and the shared pathogenic mechanisms between cancer and cardiovascular diseases.4
CTR-CVT encompasses a spectrum of cardiovascular injuries induced by chemotherapy, radiotherapy, and targeted therapies, including coronary artery disease (CAD), cardiomyopathy, heart failure (HF), myocarditis, arrhythmias, vascular toxicities, hypertension, pericardial diseases, and valvular heart diseases (VHD), which now represent the second leading cause of morbidity and mortality among cancer survivors4 (Figure 2 and Supplementary data: Table S1) . Cancer survivors face a 2-to 5-fold elevated CVD-related mortality risk relative to the general population.5 Notably, CVD constitutes the leading cause of non-oncologic mortality in this population, reducing 8-year overall survival from 81% to 60% compared to those | [https://doi.org/10.2147/DDDT.S572304](https://doi.org/10

FAQs

What is cancer therapy-related cardiovascular toxicity (CTR-CVT)?

CTR-CVT is a spectrum of cardiovascular injuries induced by chemotherapy, radiotherapy, and targeted therapies, with both acute manifestations during treatment and delayed presentations that can persist for years.

Why is longitudinal monitoring important for cancer survivors?

Because CTR-CVT can appear acutely during therapy and later as delayed sequelae, survivorship requires rigorous longitudinal cardiovascular risk stratification, including assessment, imaging, and biomarker-guided surveillance.

Which major research and clinical priorities are highlighted for the future?

The review prioritizes clarifying CTR-CVT pathophysiological mechanisms, developing cardio-protective strategies, implementing personalized therapeutic protocols, and reducing disparities in care.

Sep 23, 2026

Uploaded by Rowan