[Comment] Secondary prevention of anthracycline cardiotoxicity in childhood cancer survivors

Anthracyclines are a class of chemotherapeutic drugs widely used in the treatment of childhood cancer that are well known for their dose-dependent association with heart failure even decades after exposure.1 Heart failure is typically preceded by an asymptomatic phase of cardiac dysfunction, during which preventive actions can be taken to halt the progression to heart failure.2 However, solid evidence for secondary prevention in individuals who have undergone treatment for childhood cancer (ie, childhood cancer survivors) is unavailable, and questions remain over when secondary preventive actions would be beneficial—for instance, in which survivors, at what time after anthracycline exposure, and at what degree of cardiac dysfunction.