{"entity":{"id":"idea-moon-cardioprotection-by-default","kind":"idea","name":"Biomarker-guided cardioprotection for everyone on cardiotoxic cancer therapy","aka":[],"tldr":"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.","summary":"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.","asOf":"2026-09-08","links":[{"label":"Bottleneck evidence (Toxicity and quality of life are undervalued): Di Maio et al., Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting (JCO 2015)","url":"https://doi.org/10.1200/JCO.2014.57.9334"}],"tags":[],"related":[],"cancers":["breast-her2-positive","dlbcl"],"sections":[],"technologies":["cardio-oncology"],"targets":[],"drugs":["trastuzumab"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol","b-survivorship"],"keyPapers":["paper-di-maio-j-clin-oncol"],"journals":[],"dependsOn":[],"notes":[],"hypothesis":"Biomarker-guided cardioprotection halves the incidence of cancer therapy-related cardiac dysfunction at two years and reduces treatment interruptions for cardiac reasons.","rationale":"Cardiac injury is detectable before it is symptomatic and several inexpensive drugs plausibly protect; the field lacks a standardised, tested pathway rather than candidate interventions.","test":"Pragmatic multi-centre trial randomising centres to the algorithmic programme versus usual care with cardiac dysfunction and oncology dose delivery as co-primary endpoints.","maturity":"early-clinical","actor":"research","cost":"medium","horizonYears":4},"route":"/ideas/idea-moon-cardioprotection-by-default/","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/"}],"technology":[{"id":"cardio-oncology","kind":"technology","name":"Cardio-oncology","route":"/technologies/cardio-oncology/"},{"id":"cardiotoxicity-surveillance-recovery","kind":"technology","name":"Heart function after anthracyclines, trastuzumab and chest radiotherapy","route":"/technologies/cardiotoxicity-surveillance-recovery/"},{"id":"anthracycline-cardioprotection","kind":"technology","name":"Protecting the heart during anthracycline treatment: dexrazoxane, beta blockers and ACE inhibitors","route":"/technologies/anthracycline-cardioprotection/"},{"id":"rejuv-paed-heart","kind":"technology","name":"The heart after anthracyclines and chest radiotherapy in childhood","route":"/technologies/rejuv-paed-heart/"}],"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/"}],"paper":[{"id":"paper-di-maio-j-clin-oncol","kind":"paper","name":"Symptomatic toxicities experienced during anticancer treatment: agreement between patient and physician reporting in three randomized trials","route":"/key-papers/paper-di-maio-j-clin-oncol/"}],"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/"}]}}