A powerful shift is happening in the world of medicine — where cancer care meets heart health. The 2025 Global Cardio-Oncology Summit (GCOS2025), organized by the Cardio Oncology Society of Southern Africa (COSOSA), is currently taking place from October 30 to November 1 in Cape Town, South Africa. This international gathering brings together leading minds from around the world to discuss one of the most complex frontiers in modern healthcare: how to protect the heart while treating cancer.
At the event, Alexandra Pons Riverola, a Clinical Fellow in Cardio-Oncology at the Royal Brompton and Harefield Hospitals, shared her reflections and key learnings on LinkedIn. Her posts capture some of the most exciting — and sometimes controversial — developments in this fast-evolving field.
The Future of Cardio-Oncology: Where Are We Headed?
During an inspiring lecture by Dr. Alexander Lyon, delegates explored the urgent priorities shaping cardio-oncology research today.
- The field is growing increasingly intricate as new cancer treatments emerge, many of which bring previously unseen cardiovascular risks.
- Despite rapid advances, large gaps remain — meaning ongoing, targeted research is more vital than ever.
- Artificial Intelligence could soon revolutionize the field by helping clinicians predict cardiac toxicity, assess risk, and personalize treatment with unmatched precision.
But here’s where it gets interesting: can AI truly replace the intuition and experience of seasoned cardiologists, or should it remain a supporting tool? This remains a hot topic among experts.
Session 1: Cardio-Oncology in Africa — A Region on the Rise
The first session highlighted Africa’s growing contribution to basic science in cardio-oncology — a field often overlooked in global research discussions.
- Cancer-induced inflammation and blood clotting risks are major triggers for cardiac complications. Researchers across Africa are now uncovering the molecular mechanisms behind these processes, paving the way for targeted, region-specific therapies.
- Excitingly, HDL particles may serve as both biomarkers and potential therapeutic targets for doxorubicin-induced cardiotoxicity — a breakthrough concept in early detection.
- And in a fascinating twist, some traditional African plants are showing cardioprotective potential. While laboratory results are promising, scientists emphasize that rigorous human clinical trials are still needed.
Could Africa become the next powerhouse in cardio-oncology innovation? Many believe it’s only a matter of time.
Session 2: Novel Insights Transforming Cardio-Oncology
The second session dove deep into the molecular frontiers of heart-cancer interactions.
- Nesprin-2 and chromatin are gaining attention as key regulators that help the heart resist abnormal cancer cell proliferation when under mechanical stress.
- Ferroptosis, a specific type of cell death, has emerged as a major player in both cancer biology and heart disease — positioning it as a potential “bridge mechanism” linking the two.
- The endothelium, far from being a passive barrier, may actively guide cancer cells as they invade and spread.
And this is the part most people miss: cardio-oncology isn’t just about managing drug side effects — it’s uncovering fundamental biological connections between the heart and cancer.
Session 3: Anthracycline-Induced Cardiotoxicity — A Double-Edged Sword
This session tackled one of oncology’s biggest dilemmas: how to use powerful drugs like anthracyclines without damaging the heart.
- Early stages of doxorubicin toxicity show a hypermetabolic phase fueled by glucose, which later leads to irreversible mitochondrial injury. Remarkably, SGLT2 inhibitors may help counteract this effect.
- Research shows that women with peripartum cardiomyopathy (PPCM) face a higher risk of developing cancer compared to peers without PPCM.
- In animal models, early-life exposure to doxorubicin increased the likelihood of heart failure and death during pregnancy — raising ethical and clinical concerns about treatment timing.
- Certain genetic mutations linked to cardiomyopathy can heighten a patient’s vulnerability to drug-induced heart damage.
- Scientists also found that hexokinases play complex roles in both heart failure and cardiotoxicity, with potential for future drug targeting.
- Perhaps most excitingly, EPAC 1 inhibition appears to protect the heart from doxorubicin-induced injury without reducing its anti-cancer power — a possible game changer for future therapies.
Should oncologists begin screening for genetic heart-risk factors before prescribing anthracyclines? This question sparked lively debate at the conference.
GCOS25 Day 2: Managing Acute Cardiac Emergencies in Cancer Patients
The second day opened with a deep dive into emergency cardiac care for cancer patients — a setting where every minute counts.
- The idea of “permissive cardiotoxicity” was emphasized: sometimes mild cardiac stress is acceptable if it means a patient can complete life-saving cancer therapy. Studies show over 90% of patients can successfully finish treatment despite manageable heart issues.
- Common emergencies, like cardiac tamponade or superior vena cava obstruction, often rely heavily on clinical judgment for diagnosis and management.
- When cancer patients suffer acute coronary syndromes (ACS), doctors must weigh treatment risks carefully. Yet evidence supports invasive procedures using radial access, third-generation stents, and short dual antiplatelet therapy to lower bleeding risks.
- General practitioners (GPs) play an essential — yet often underappreciated — role in long-term cardio-oncology follow-up and early detection.
The Takeaway: A Global Collaboration for a Healthier Future
GCOS2025 isn’t just another conference — it’s a call to action. As cancer survival rates improve, cardio-oncology becomes a defining frontier of patient-centered medicine. From African research labs to London hospitals, scientists are uniting under one mission: to ensure that surviving cancer doesn’t come at the cost of heart health.
But what do you think — should the focus in cancer care shift more toward long-term heart protection, even if it means adjusting or slowing aggressive treatments? Or should oncologists continue to prioritize eliminating cancer first, and manage heart effects later?
Let’s hear your thoughts in the comments below — this debate could shape the future of global healthcare.
