LAUSR

In the past decades potent antineoplastic treatments brought hope to the millions of patients with cancer. As a result of increased survival rates and prolonged life expectancy, cardiotoxicity presents as a significant complication of several old therapies, including anthracyclines, but also newer antineoplastic treatments, such as immunotherapy. In turn, the number of cancer survivors being affected by cardiovascular (CV) disease is steadily increasing.1–3 There is an intense scientific interest in cardiotoxicity, but the understanding, definition, and treatment of patients with CV disease prior or due to antineoplastic treatment is still largely opinion-based, in the absence of strict evidence-based guidelines. Likely, patients prone to cardiotoxic complications may benefit from pre-emptive CV treatments. However, the overall risk for cardiotoxicity is not very high in many patients and inter-individual responses to antineoplastic treatments vary significantly. Therefore, it remains challenging to identify patients who will benefit from such treatments. Several studies have explored if elevations in CV biomarkers, most notably natriuretic peptides (NPs) and cardiac troponins (cTn) could be used to guide CV treatments.4–7 However, these studies had small sample size and heterogeneous populations. At current, there is no consensus on the use of biomarkers and CV treatments in patients with cancer. There is a pressing need for prospective data to prove (or disprove) if cardiac biomarkers could predict LV systolic dysfunction in patients receiving antineoplastic treatments. In the current issue of the Journal, Michel et al.8 recognized the importance of this and present a systematic analysis of the data available in an effort to find optimal diagnostic and prognostic cardiotoxicity biomarkers. The authors focused their meta-analysis