{"entity":{"id":"idea-acc-risk-stratified-cardio-oncology-pathway","kind":"idea","name":"A risk-stratified cardio-oncology pathway for everyone receiving heart-toxic cancer therapy","aka":[],"tldr":"Some chemotherapy and antibody drugs damage the heart. Checking heart function before and during treatment and starting protective drugs early for those at risk could prevent much of that damage.","summary":"Anthracyclines, HER2-targeted therapy, and some kinase inhibitors cause cardiac dysfunction that is often detected late. Guidelines (ESC 2022 cardio-oncology) recommend baseline risk assessment, biomarker and strain-imaging surveillance, and cardioprotective therapy for high-risk patients, but implementation is inconsistent and cardio-oncology clinics are rare outside academic centres. A pathway with automatic risk scoring at prescription, scheduled surveillance, and protocolised initiation of protective therapy would standardise this.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Survivorship and late effects are neglected): NCI Office of Cancer Survivorship statistics","url":"https://cancercontrol.cancer.gov/ocs/statistics"}],"tags":[],"related":[],"cancers":["breast-her2-positive","dlbcl"],"sections":["supportive-care","rejuvenation"],"technologies":["cardio-oncology"],"targets":[],"drugs":["trastuzumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-survivorship","b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Systematic risk-stratified cardio-oncology care will reduce the incidence of symptomatic heart failure within five years of treatment by at least 30% and reduce premature discontinuation of HER2-targeted therapy.","rationale":"Early detection of subclinical dysfunction and prompt cardioprotection improve recovery in trials; the gap is systematic application rather than evidence.","test":"A cluster-randomised implementation across 20 hospitals with heart failure incidence, treatment completion, and cardiovascular death as endpoints.","maturity":"being-tested-at-scale","actor":"clinic","cost":"medium","horizonYears":3},"route":"/ideas/idea-acc-risk-stratified-cardio-oncology-pathway/","neighbours":{"cancer":[{"id":"dlbcl","kind":"cancer","name":"Diffuse large B-cell lymphoma","route":"/cancers/dlbcl/"},{"id":"breast-her2-positive","kind":"cancer","name":"HER2-positive breast cancer","route":"/cancers/breast-her2-positive/"}],"section":[{"id":"rejuvenation","kind":"section","name":"Recovery & Rejuvenation","route":"/fronts/rejuvenation/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"technology":[{"id":"cardio-oncology","kind":"technology","name":"Cardio-oncology","route":"/technologies/cardio-oncology/"}],"drug":[{"id":"trastuzumab","kind":"drug","name":"Trastuzumab","route":"/drugs/trastuzumab/"}],"bottleneck":[{"id":"b-survivorship","kind":"bottleneck","name":"Survivorship and late effects are neglected","route":"/bottlenecks/b-survivorship/"},{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}],"roadmap":[{"id":"survivorship-roadmap","kind":"roadmap","name":"Supportive care and survivorship roadmap: making treatment bearable → proving it extends life → caring for tens of millions afterwards","route":"/roadmaps/survivorship-roadmap/"}]}}