Cardio-Oncology: Addressing Unmet Needs at ESC Cardio Oncology 2026

The field of cardio-oncology addresses the cardiovascular complications arising from cancer and its treatments. As cancer survival rates improve due to more effective therapies, the long-term cardiovascular health of these patients has become a pressing concern. Many antineoplastic agents, including anthracyclines, HER2-targeted therapies, tyrosine kinase inhibitors, and immune checkpoint inhibitors, are associated with various forms of cardiotoxicity.¹ This can manifest as left ventricular dysfunction, heart failure, hypertension, arrhythmias, myocardial ischaemia, and thromboembolic events.² The prevalence of pre-existing cardiovascular risk factors in the cancer patient population further complicates management, often leading to worse cardiovascular outcomes.³

The European Society of Cardiology (ESC) Cardio-Oncology 2026 meeting aims to consolidate current knowledge and foster future advancements in this rapidly evolving area. The meeting's focus on unmet needs underscores several critical gaps in current practice. These include the lack of standardized screening protocols for cardiotoxicity, insufficient integration of cardiovascular and oncological care, and a limited evidence base for managing specific cardiotoxicities in diverse patient populations.⁴ For instance, while anthracycline-induced cardiotoxicity is well-documented, the long-term cardiovascular effects of newer targeted therapies and immunotherapies are still being elucidated.⁵

Advancing the Field Together

Addressing these unmet needs requires a concerted effort across multiple disciplines. One primary area of focus is the development and implementation of harmonized guidelines for cardiovascular risk assessment and monitoring in cancer patients. Current practices vary widely, leading to inconsistencies in patient care.⁶ The ESC guidelines on cardio-oncology provide a framework, but practical implementation remains a challenge, particularly in resource-constrained settings.⁷

Another significant unmet need is the establishment of integrated care models. Effective cardio-oncology programmes involve close collaboration between cardiologists, oncologists, primary care physicians, and other specialists. These programmes aim to optimize patient outcomes by facilitating timely diagnosis and management of cardiovascular complications while ensuring uninterrupted cancer treatment.⁸ Data from existing integrated clinics suggest improved patient adherence to monitoring protocols and earlier detection of cardiotoxicity, though large-scale randomized trials demonstrating superiority over fragmented care are still emerging.⁹

Research into novel cardioprotective strategies is also a key area. While some agents, such as beta-blockers and ACE inhibitors, have shown promise in mitigating anthracycline-induced cardiotoxicity, their routine use as primary prevention is not universally established.¹⁰ Further research is needed to identify biomarkers that can predict cardiotoxicity more accurately, allowing for personalized risk stratification and targeted interventions.¹¹ For example, high-sensitivity troponin and natriuretic peptides are increasingly used for early detection of cardiac injury, but their precise role in guiding treatment modifications requires further validation.¹²

Finally, there is a recognized need for enhanced education and training in cardio-oncology for both cardiologists and oncologists. Many clinicians lack specialized training in managing the complex interplay between cancer and cardiovascular disease, which can lead to suboptimal patient care.¹³ Educational initiatives, such as those promoted by the ESC, are vital to equip healthcare professionals with the necessary expertise to address these challenges effectively. The ESC Cardio-Oncology 2026 meeting serves as a platform to disseminate best practices, present new research, and foster collaborative networks to advance the field.