Pediatric Cardio-Oncology: From Gap in Evidence to Future Perspectives

Area of Science:

• Cardio-oncology
• Pediatric oncology
• Cardiovascular medicine

Background:

• Improved survival in pediatric cancer patients has increased focus on long-term treatment side effects.
• Cardiotoxicity is a leading cause of morbidity and mortality in childhood cancer survivors.
• Existing evidence in pediatric cardio-oncology is limited, hindering optimal patient care.

Purpose of the Study:

• To comprehensively review the current landscape of pediatric cardio-oncology.
• To identify and critically discuss evidence gaps in surveillance, prevention, and management of cardiovascular complications.
• To highlight key areas for future research and clinical development in the field.

Main Methods:

• Comprehensive narrative and scoping review.
• Critical analysis of current clinical guidelines, landmark studies, and consensus papers in pediatric cardio-oncology.
• Assessment of evidence heterogeneity and limitations regarding cardiovascular complication management.

Main Results:

• Significant evidence gaps persist in pediatric cardio-oncology.
• Clinical practice shows considerable variability, with underdiagnosis/undertreatment of cardiovascular risk factors.
• There is a critical need for international collaborative research to address these issues.

Conclusions:

• A substantial evidence gap hinders optimal care for childhood cancer survivors regarding cardiotoxicity.
• International collaboration is essential to advance pediatric cardio-oncology.
• The goal is to shift towards a predictive and preventive specialty for improved long-term cardiovascular health in survivors.