Biomarker-guided cardioprotection for everyone on cardiotoxic cancer therapy
Anthracyclines, HER2 drugs and some newer agents can damage the heart. Monitor with blood tests and scans and start cheap heart-protective drugs early in those at risk.
Cardio-oncology has grown as a specialty but access is patchy and protective strategies (dexrazoxane, statins, ACE inhibitors, beta-blockers, SGLT2 inhibitors) have mostly small or mixed trials. The proposal is a unified, algorithmic programme: baseline risk score, troponin and strain imaging surveillance at defined points, protocolised initiation of protective therapy on early signals, and a linked registry, tested in a pragmatic randomised trial across anthracycline, HER2 and immune checkpoint regimens.
- Toxicity and quality of life are undervalued · Trials measure how long people live, not how they live. Side-effects are under-reported and under-treated.
- Survivorship and late effects are neglected · Tens of millions of people live after cancer with heart damage, infertility, second cancers and fear, and few services.
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