From Reactive Cardiotoxicity Management to Risk-Proportional Cardio-Oncology Care

Cancer survival has improved dramatically, yet the cardiovascular cost of that progress remains unevenly understood and inconsistently managed. Cardio-oncology sits at one of medicine’s most consequential intersections: where life-prolonging therapy and cardiovascular safety must be weighed together, honestly and in real time. Despite growing clinical awareness, practice varies widely across institutions and healthcare systems, not only because of resource differences, but because the field still lacks shared frameworks for translating biomarker and imaging data into treatment decisions that patients and clinicians can trust.The central problem is not simply cardiotoxicity. It is the persistent tendency to manage it reactively and in isolation, treating cardiovascular risk as a complication to contain rather than a dimension of care to integrate. This Research Topic challenges that framing. We are seeking work that supports a shift toward risk-proportional, patient-centered cardio-oncology: approaches that allow transparent, context-sensitive risk-benefit evaluation, reduce both under-detection of meaningful toxicity and unnecessary disruption of effective cancer therapy, and translate across the full diversity of real-world healthcare settings.We are particularly interested in research that builds shared conceptual language and practical tools that can be implemented sustainably, not only in well-resourced academic centers, but across the global spectrum of cardio-oncology care.We welcome manuscripts addressing:• Risk-proportional cardio-oncology surveillance;• BEST (Biomarkers, EndpointS, and Tools) resources (NIH-FDA);• Estimand (ICH-E9R1) and decision science;• Survivorship and longitudinal cardiovascular risk;• Real-world evidence and implementation science;• Shared decision-making and patient-centered care models;• Sustainable cardio-oncology guidance beyond “one-size-fits-all” approaches. Topic editors: Kazuko Tajiri, Kazuhiro Sase, Naohiro Yonemoto Source: https://www.frontiersin.org/research-topics/81663/from-reactive-cardiotoxicity-management-to-risk-proportional-cardio-oncology-care