Cardio-Oncology Surveillance States: a mechanism-informed framework for cardiovascular risk across the cancer continuum
Year: 2026
Type: article
Abstract: 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. Diverse cancer therapies converge on shared myocardial, vascular, and immune injury pathways, limiting therapy-specific surveillance approaches. Cardio-Oncology Surveillance States (COSS) define a dynamic, mechanism-informed framework that aligns monitoring intensity with evolving biological risk. Bidirectional cancer–cardiovascular biology reframes cardio-oncology beyond treatment-related toxicity, positioning prevention as central to long-term outcomes.
Source: Cardio-Oncology
Authors: Aleksandra Lange, Przemysław Palka, Liam Griffiths, Melissa E. Reichelt, Janusz Lange, Ava Allen, J. Elisabeth Donnelly, Maree Colosimo, James Morton, Kerry Taylor, Vikram Jain, Mohamed Shanavas, Jacqueline Taylor, Emma Taylor, Vladimir Andelkovic, Jason Butler, Raymond Banh, Stephen Fanning, Karthik Nath, Jim Coward, Walter G. Thomas
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,790
OpenAlex ID: W7222160282
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