Permissive Cardiotoxicity: An Evolving Paradigm
- 1David Geffen School of Medicine at UCLA
Abstract
Permissive cardiotoxicity is an evolving clinical practice pattern that balances the management of cancer treatment-associated cardiotoxicities with the risk of interrupting lifesaving or life-extending cancer treatments. This paradigm shift has been catalyzed by advancements in the diagnostic and therapeutic tools available to treating clinicians, as well as a recognition of the consequences of withholding or delaying cancer therapy. Permissive cardiotoxicity has become a central tenet in the practice of cardio-oncologists; however, recognition and confidence in managing cardiotoxicity is also crucial for the general cardiologist and oncologist due to the growing population of patients with cancer. This review aims to (1) highlight the philosophy of permissive cardiotoxicity, (2) provide a framework for risk stratification of cardiovascular toxicities, (3) describe systems of care considerations for successful implementation of permissive cardiotoxicity, and (4) review the existing literature and guideline recommendations for specific cardiovascular toxicity mitigation.
Related
- SOHO State of the Art Updates and Next Questions | The Evolving AML Treatment Paradigm
- Transthyretin cardiac amyloidosis: an evolving paradigm in recognition, diagnosis, and treatment
- Permissive Blood Pressure Targets in Pediatric Critical Care
- “Cell Village” Captures Populational Heterogeneity of Sunitinib Cardiotoxicity
- Extracellular vesicle-encapsulated GDF15 alleviates doxorubicin-induced cardiotoxicity via the SUB1/TERT/TPP signalling axis
BibTeX
@article{madnick2026permissive,
title = {{Permissive Cardiotoxicity: An Evolving Paradigm}},
author = {David L. Madnick and Elizabeth Hutchins and Ashley F. Stein‐Merlob and Eric H. Yang},
journal = {Journal of the American Heart Association},
year = {2026},
month = oct,
doi = {10.1161/jaha.126.051633},
url = {https://www.ahajournals.org/doi/10.1161/JAHA.126.051633},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Permissive Cardiotoxicity: An Evolving Paradigm
AU - David L. Madnick
AU - Elizabeth Hutchins
AU - Ashley F. Stein‐Merlob
AU - Eric H. Yang
PY - 2026
DA - 2026/10/20
JO - Journal of the American Heart Association
DO - 10.1161/jaha.126.051633
UR - https://www.ahajournals.org/doi/10.1161/JAHA.126.051633
AB - Permissive cardiotoxicity is an evolving clinical practice pattern that balances the management of cancer treatment-associated cardiotoxicities with the risk of interrupting lifesaving or life-extending cancer treatments. This paradigm shift has been catalyzed by advancements in the diagnostic and therapeutic tools available to treating clinicians, as well as a recognition of the consequences of withholding or delaying cancer therapy. Permissive cardiotoxicity has become a central tenet in the practice of cardio-oncologists; however, recognition and confidence in managing cardiotoxicity is also crucial for the general cardiologist and oncologist due to the growing population of patients with cancer. This review aims to (1) highlight the philosophy of permissive cardiotoxicity, (2) provide a framework for risk stratification of cardiovascular toxicities, (3) describe systems of care considerations for successful implementation of permissive cardiotoxicity, and (4) review the existing literature and guideline recommendations for specific cardiovascular toxicity mitigation.
SN - 2047-9980
ER -