New Risk Score Improved Chemotherapy Heart Safety
A new tool helps clinicians predict and monitor heart damage risk for patients receiving chemotherapy.
Updated on Oct. 1, 2026 in Heart Disease
Live Poll
Do you believe combining multiple diagnostic tools is better for your personal health outcomes?
Researchers have developed the RE-ACT score, a new method to predict the likelihood of chemotherapy-induced heart toxicity within a patient's first year of treatment. This model is designed to be used alongside existing stratification tools to improve the accuracy of heart health monitoring for cancer patients.
Why it matters
Current risk assessment systems are often too complex for consistent use in busy clinics, which can delay the detection of heart complications. A more accurate and streamlined scoring model could improve care by identifying high-risk individuals earlier.
In a retrospective study of 2,612 patients and a validation cohort of 819, researchers demonstrated that the RE-ACT model achieved an AUC-ROC of 0.83, while the combined approach reached 0.87. This predictive performance compares to an AUC-ROC of 0.76 for the existing HFA-ICOS tool alone.
The players
European Institute of Oncology
An Italian research and clinical institution that studies cancer treatment protocols and associated toxicities.
The details
The RE-ACT score functions by integrating baseline clinical variables, the total cumulative dose of anthracycline chemotherapy, and changes in Left Ventricular Ejection Fraction (LVEF) measured within one month after starting treatment. By identifying an LVEF decline of over 10 percentage points to below 50% or the onset of symptomatic heart failure, the tool helps clinicians identify those at greatest risk. It is intended for use in tandem with the HFA-ICOS stratification tool, which incorporates prior cardiovascular history and cardiac biomarkers.
Timeline
June 1995 to May 2014: Treatment window for the derivation cohort.
Within 1 month after treatment: LVEF measurement timing for the RE-ACT model.
Within the first year: The primary prediction window for potential cardiotoxicity.
Over 2 years: Follow-up period for the HFA-ICOS risk assessment.
Health Landscape
This development represents an iterative improvement on the HFA-ICOS risk stratification tool currently used in oncology. It highlights a growing shift toward integrating rapid-response biomarkers into standard care to manage the known side effects of anthracycline-based therapies.
If you are beginning chemotherapy, discuss with your oncology team what tools they use to monitor heart function and assess your personal risk of toxicity. It is worth asking your doctor how often they will check your cardiac markers during the first year of your treatment.
The takeaway
The RE-ACT model provides a more accurate way for clinicians to track heart health during the first year of chemotherapy. Patients should feel empowered to ask their physicians about the specific monitoring protocols in place to identify potential heart toxicity early.
Further reading
For more on managing long-term heart health during cancer treatment, explore our Heart Disease section.
Source note: This article includes information reported by Healio.
Live Poll
Do you believe combining multiple diagnostic tools is better for your personal health outcomes?
