Immunotherapy-Associated Cardiovascular Toxicity: Mechanisms, Biomarkers, and Prevention

The field of cardio-oncology is confronted with the dual challenge of harnessing the life-prolonging benefits of cancer immunotherapies while navigating their potential for serious cardiovascular complications. As therapies such as immune checkpoint inhibitors, CAR-T cells, and novel immunomodulators gain prominence, clinical reports increasingly document cases of myocarditis, vasculitis, and rapidly progressive atherosclerosis as adverse events. These complications not only jeopardize cardiovascular health but also threaten the continuity and success of life-saving cancer treatments. Although heightened awareness has led to important early studies and registry data, comprehensive understanding of the underlying mechanisms, validated biomarkers for early detection, and scalable approaches for prevention remains limited. Significant knowledge gaps persist in both the foundational science of immunotherapy-induced injury and the ability to translate mechanistic insights into practical interventions.This Research Topic aims to drive the next wave of progress by uniting basic scientists, translational researchers, and clinicians around the multifaceted challenge of immunotherapy-associated cardiovascular toxicity. It seeks to illuminate the cellular and molecular underpinnings of myocarditis, vasculitis, and immune-mediated atherosclerosis as triggered by various cancer immunotherapies. Central objectives include defining actionable biomarkers for risk stratification and monitoring, as well as identifying, validating, and implementing prevention or mitigation strategies that minimize cardiovascular events without compromising anticancer efficacy. Key questions to be addressed involve the identification of causal pathways, the development of integrative diagnostic frameworks, and the translation of molecular insights into evidence-based patient care.The scope of this Research Topic spans basic, translational, and clinical investigations, while emphasizing clinically actionable insights and innovative methodologies. Studies may cover mechanisms of immune-related cardiovascular injury, novel circulating and imaging biomarkers, and practical prevention strategies. Research should clearly contextualize the immunotherapeutic agent, dosing, timing, and cardiovascular endpoint. We invite original and collaborative research, encompassing both adult and pediatric populations with diverse cancers. To advance this field, we welcome articles exploring, but not limited to, the following themes:• Cellular and molecular mechanisms of immunotherapy-induced myocarditis, vasculitis, and atherosclerosis• Development and validation of circulating and imaging biomarkers for early detection and risk stratification• Integrated multi-omics and imaging-based risk scores, including machine learning approaches• Translational prevention and mitigation strategies that balance cardioprotection and anticancer efficacy• Surveillance protocols, detection algorithms, and their implementation in oncology-cardiology practice• Standardization and harmonization of cardiotoxicity definitions and reproducible methods• Considerations for diverse populations, cancer types, and multicenter collaborationsAppendix: We encourage submissions in the form of Original Research, Brief Research Reports, Reviews, Mini-Reviews, Systematic Reviews, Meta-Analyses, Methods, Clinical Trial Protocols and Reports, Hypothesis and Theory articles, and Perspectives. Contributions from multicenter collaborations, registries, and data-driven modeling studies are particularly valued. Topic editors: Inbar Nardi Agmon, Yusuf Ziya ŞENER Source: https://www.frontiersin.org/research-topics/79283/immunotherapy-associated-cardiovascular-toxicity-mechanisms-biomarkers-and-prevention