Cardio-Oncology
Living Guideline
This site offers two resources for clinicians: a continuously updated cardio-oncology guideline — every 2022 ESC recommendation reviewed against new 2023–2026 evidence — and an integrated prostate-cancer cardiovascular risk calculator for rapid triage and PREVENT-based 10-year risk scoring.
Two Clinical Resources, One Goal
Evidence-Based
Every update is grounded in peer-reviewed publications, RCTs, and society consensus statements.
Continuously Updated
Sections are revised as new evidence emerges. Version dates are displayed for full transparency.
Feedback-Driven
Clinicians can submit corrections, new references, or suggested changes directly through the site.
Browse Sections
Recent Updates
October 2026
§5.5.4, 5.5.11–5.5.12, 5.5.18, 7.4–7.5, 8.1–8.3, 15
October review: two FDA boxed/regimen warnings and the 2026 ESC cardiac-rehabilitation guideline
Camizestrant (ETCAMAH) boxed warning for arrhythmia risk with concomitant QTc-prolonging drugs, particularly ribociclib (ECG, electrolyte and heart-rate monitoring; SERENA-6); belzutifan–lenvatinib cardiac-dysfunction warning (grade ≥3 in 6%, LVEF decrease >20% in 6%, LITESPARK-011); formal 2026 ESC CORE grades (IIa B1/IIb B2/IIa B2) replacing the provisional Section 8.1 exercise language; explicit <100 mg/m² and <15 Gy childhood-survivor low-risk thresholds with IGHG equivalence ratios; 2026 AHA coronary-atherosclerosis statement in Section 8.3; and the Danish 91,407-survivor cohort caution in Section 8.1.2.
September 2026
§12–15
Sections 12–15 added: key messages, future needs, evidence gaps and the change-only recommendation register
Eighteen updated key messages integrating all 2023–2026 evidence appraisals; the revised research agenda and domain-by-domain evidence gaps with RADICAL-PC2, PRADA II, SARAH, REVELUTION and the fluoropyrimidine prevention RCT newly resolved to their published articles; and a change-only "what to do / what not to do" register covering AF framework updates, EAQ191 blood-pressure targets, statin cardioprotection (STOP-CA and meta-analysis), reduced-dose extended apixaban (API-CAT/EVE), the tranexamic-acid no-benefit finding (TREATT), PMAP balloon pericardiotomy and amivantamab–lazertinib VTE prophylaxis.
September 2026
§9.3–11
Sections 9.3–9.5 and 10–11 added: carcinoid heart disease, AL amyloidosis, CIEDs and patient communication
Carcinoid heart disease screening, PFO risk and surgical outcomes updates; the ANDROMEDA final survival analysis and AL International Staging System for light-chain cardiac amyloidosis; contemporary radiotherapy safety cohorts and dosimetric criteria for cardiac implantable electronic devices; and patient self-management evidence including the CHIIP trial, digital-intervention meta-analyses and the ESC Core Curriculum for cardio-oncology.
September 2026
§8.7–9.2.2
Sections 8.7–8.10 and 9 added: late arrhythmias, pregnancy and cardiac tumours
Radiation-associated arrhythmias with cardiac-substructure dosing, cardiometabolic risk management with the CHALLENGE exercise trial, pregnancy in cancer survivors and pregnant patients with cancer (2025 ESC pregnancy guideline), updated childhood-cancer prediabetes risk, cardiac-tumour imaging with CMR and FDG-PET meta-analyses, and cancer-associated pregnancy VTE quantification.
September 2026
§8–8.6
Section 8 added: long-term follow-up and survivorship phenotypes
Updated childhood-cancer cardiomyopathy surveillance thresholds (2023 ILCHG), long-term anthracycline/HER2 and HSCT risk, radiation substructure dose and coronary calcium, the 2026 ESC heart-failure guideline cross-reference, the 2025 valvular heart disease guideline, and late PAD, stroke and pericardial guidance.
September 2026
§7–7.5
Section 7 added: end-of-therapy assessment, medication withdrawal and rehabilitation
First-year surveillance guidance with dynamic risk re-stratification (RE-ACT), the randomized HER-SAFE withdrawal trial for recovered anti-HER2 CTRCD, the CORE cardio-oncology rehabilitation RCT, and quantitative cardiorespiratory-fitness evidence.
September 2026
§6.7–6.10.2
Bleeding, PAD, pulmonary hypertension and pericardial disease pages added
PRECISE-DAPT Cancer and ONCO-DOAC BLEED bleeding scores, the no-benefit TXA trials (A-TREAT/TREATT), the 2024 ACC/AHA PAD guideline, comparative dasatinib PAH risk, the 2025 ESC pericarditis guideline, and the randomized PMAP balloon pericardiotomy trial.
September 2026
§6.6–6.6.4.2
Thrombosis and anticoagulation pages added
Updated VTE/ATE incidence estimates, dynamic thrombotic-risk assessment including CDK4/6 inhibitors, reduced-dose extended apixaban (API-CAT/EVE), the CANVAS randomized trial, and upgraded ambulatory and postoperative prophylaxis recommendations.
September 2026
§6.4.2 & 6.4.3, 6.5
QT, bradyarrhythmia and hypertension pages added
CDK4/6 inhibitor QTc meta-analysis, delayed osimertinib QT toxicity, ICI conduction disease as myocarditis, the 2024 ESC hypertension targets, and the randomized EAQ191 intensive blood-pressure trial in VEGFR TKI patients.
September 2026
§6.2–6.4.1
Coronary disease, valvular disease and arrhythmia management pages added
Cancer-specific hs-cTn performance, the ONCO-ACS risk score, individualized DAPT, the 2025 ESC/EACTS valvular heart disease guideline, and the AF-CARE/CHA2DS2-VA framework.
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