https://orcid.org/0000-0002-3414-7022
The field of cardio-oncology is rapidly gaining momentum, driven by growing clinical and research interest. This progress reflects a heightened awareness of the cardiovascular challenges patients face throughout their cancer journey, including cancer treatment-induced cardiovascular toxicities,1 direct cardiac complications of cancer, and the increased cancer risk associated with chronic cardiovascular conditions such as heart failure or ischaemic heart disease.2
As cancer prognoses continue to improve, the cardiologist of the future must be equipped to collaborate within multidisciplinary teams to address the challenges of cardio-oncology and improve patient outcomes. Recognizing these demands, the European Society of Cardiology (ESC) established the ESC Council of Cardio-Oncology (ESC-CCO) (https://www.escardio.org/Councils/council-of-cardio-oncology) in 2018. The ESC-CCO’s mission is to reduce the cardiovascular burden for patients with cancer and survivors by fostering interdisciplinary collaboration and promoting personalized care strategies. To achieve its objectives, the ESC-CCO operates on four fundamental pillars: education and training, quality of care, research, and advocacy (Figure 1).
Key strategic pillars of the ESC Council of Cardio-Oncology include education and training, research, quality of care, and advocacy. Partnerships with national and international societies, healthcare systems, and the adoption of technological advancements are essential for achieving sustainable cardio-oncology services
Education and training
Education is a cornerstone of the Council’s efforts. Since its foundation, the ESC-CCO has hosted numerous webinars with leading experts to disseminate the latest advances in cardio-oncology. These initiatives aim to equip healthcare providers with the essential knowledge and skills to manage cardiovascular complications in patients with cancer, according to the recommendations of the ESC guidelines.1
An important milestone was the publication of the ESC Core Curriculum for Cardio-Oncology.3 This document outlines the knowledge, skills, and attitudes required for both, general cardiologists and cardio-oncology specialists, to be well prepared to meet the cardiovascular challenges posed by cancer therapies.
The Council also launched the COOL (Cardio-Oncology Leaders for Tomorrow) group, a dedicated platform for young professionals offering mentorship, networking opportunities, and resources for early-career clinicians and researchers in cardio-oncology.
Furthermore, this year, the ESC-CCO organizes the first conference fully dedicated to cardio-oncology, ESC Cardio-Oncology 2025. This inaugural event (https://www.escardio.org/Congresses-Events/Cardio-Oncology) will further strengthen cardio-oncology as a distinct discipline and emphasize the need for its integration into general cardiology practice. Taking place in Florence on 20–21 June 2025, this conference will bring together researchers and clinicians to share the latest advances and explore the future of cardio-oncology. The scientific programme includes a wide range of interactive sessions and case-based discussions, emphasizing the importance of a multidisciplinary approach to the management of cardiovascular complications in patients with cancer. Joint sessions with leading organizations, such as the European Society of Medical Oncology, the European Haematology Association, the European Society for Therapeutic Radiology and Oncology, and the International Cardio-Oncology Society, underscore the collaborative nature of this conference and its role in driving innovation and partnerships in the field. Furthermore, the Young Investigator Award sessions and sessions co-hosted with JACC CardioOncology and the European Heart Journal underscore the Council’s commitment to advancing research in cardio-oncology.4 In addition, the conference will serve as the launchpad for new online educational modules, developed to support clinicians preparing for the upcoming ESC certification exam in cardio-oncology, scheduled for December 2025.
Quality of care
The ESC-CCO is committed to ensuring the highest quality of cardiovascular clinical care is delivered to patients with cancer. The publication of the 2022 ESC guidelines on cardio-oncology1 provides the first clinical pathway framework for high-quality cardiovascular clinical care to patients before, during, and after their cancer treatment. The guidelines emphasize a personalized approach to each patient depending upon their baseline cardiovascular risk before starting, the type of cardiotoxic cancer therapy they will receive, and specific monitoring protocols to detect any problems at an early stage. They also outline appropriate treatment pathways and algorithms for cancer patients who develop cardiovascular complications during and after their cancer treatment. Besides, the guidelines include sections on monitoring cancer survivors after completing cardiotoxic cancer therapies, on direct cardiac complications of cancer, and on the highlight of future needs and areas of research priority, in cardio-oncology.
Research
High-quality basic, translational, clinical, and epidemiological research is central to the ESC-CCO’s mission to advance understanding of cardiotoxicity mechanisms and develop personalized prevention strategies.5 One significant example is the Council’s active involvement in the RESILIENCE clinical trial.6 The ongoing RESILIENCE trial explores remote ischaemic conditioning as a non-invasive strategy to prevent anthracycline-induced cardiotoxicity in high-risk patients,7 integrating advanced cardiac magnetic resonance imaging to validate imaging biomarkers for early detection and advancing personalized cardioprotection in cardio-oncology.
The Council’s six study groups focus on innovative aspects of cardio-oncology, driving collaborative research and fostering partnerships with other ESC groups and international societies (https://www.escardio.org/Councils/council-of-cardio-oncology/About/esc-council-on-cardio-oncology-study-groups). Among their notable achievements is the development of surveys and consensus and position papers (https://www.escardio.org/Councils/council-of-cardio-oncology/Research-and-Publications) that address novel topics beyond the scope of existing guidelines,8 summarize best clinical practices,9 and offer actionable recommendations for clinicians.10 The latest recommendations on management, from the study groups, will be presented through publications and presentations at the ESC-CCO annual conference.
Advocacy and communication
Raising awareness of the importance of integrating cardio-oncology services into routine cancer and cardiology care remains a key priority. The ESC-CCO’s social media presence has grown significantly, enabling it to engage with a wider audience and share the latest updates, educational materials, and advocacy efforts in cardio-oncology. Collaboration with national cardio-oncology groups is essential to facilitate strategies to improve the implementation of clinical practice guidelines.
Looking ahead
The ESC-CCO’s achievements reflect the dedication and collaborative spirit of a large network of ESC volunteers and staff, whose efforts have been pivotal in addressing both challenges and opportunities within the field of cardio-oncology.
To sustain growth and innovation, the ESC-CCO must focus on several key areas. Strengthening partnerships with international societies and healthcare systems is essential to standardizing global practices and ensuring that patients with cancer have access to high-quality cardiovascular care. Securing long-term funding for research, education, and community-building initiatives is equally critical to maintaining momentum in the field.
As we look to the future, emerging technologies, like advanced imaging biomarkers and artificial intelligence tools, can identify patterns in patient data, predict cardiovascular risk, and personalize treatment plans for oncology patients. Incorporating these advancements, supported by basic and translational research, into clinical practice, will enhance patient outcomes and foster innovation in cardio-oncology care.
Declarations
Disclosure of Interest
T.L.-F. has received speaker, advisory board, or consultancy fees from Philips, Myocardial solutions, Janssen-Cilag, AstraZeneca, Daiichi Sankyo, Pfizer, BMS, Roche, EISAI, and Bayer. P.v.d.M. The UMCG, which employs P.v.d.M., received consultancy fees and/or grants from Novartis, Pharmacosmos, Vifor Pharma, AstraZeneca, Pfizer, Pharma Nord, BridgeBio, Novo Nordisk, Daiichi Sankyo, Boehringer Ingelheim, and Ionis. A.R.L. has received speaker, advisory board, or consultancy fees and/or research grants from Janssen-Cilag Ltd, Astellas Pharma, Pfizer, Novartis, Servier, AstraZeneca, Bristol Myers Squibb, GSK, Amgen, Takeda, Roche, Clinigen Group, Eli Lily, Eisai Ltd, Ferring Pharmaceuticals, Boehringer Ingelheim, Akcea Therapeutics, Myocardial Solutions, iOWNA Health, Heartfelt Technologies Ltd, ARMA Biosciences, and EPICLIFE.
