{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:36:55Z","timestamp":1787027815102,"version":"build-2736575974"},"reference-count":155,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T00:00:00Z","timestamp":1779408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Sex differences influence cancer incidence, treatment response, and susceptibility to cardiovascular toxicity. Males exhibit higher rates and poorer outcomes in most non-sex-specific cancers, while females more frequently experience treatment-related adverse events, including cancer therapy-related cardiac dysfunction. Biological factors such as hormonal status, genetic polymorphisms, immune responses, and pharmacokinetics contribute to these disparities. In cardio-oncology, women\u2014particularly premenopausal or with specific genotypes\u2014may be at increased risk for cardiotoxicity after treatment with anthracyclines, immune checkpoint inhibitors or radiotherapy. Clonal hematopoiesis and certain germline genetic variants such as single nucleotide polymorphisms (e.g., RARG rs2229774, HAS3 rs2232228) are emerging as potential sex-informed biomarkers for predicting cardiotoxicity risk. Despite growing evidence, sex remains insufficiently integrated into clinical trials and guideline development in cardio-oncology. This review highlights the importance of sex-specific surveillance, prevention, and multi-omic risk stratification to advance precision cardio-oncology and support better outcomes for patients across the cancer care continuum.<\/jats:p>","DOI":"10.3390\/cancers18111677","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T09:17:09Z","timestamp":1779441429000},"page":"1677","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Sex Differences in Cancer and Cardiotoxicity: Mechanisms, Outcomes, and Clinical Implications Across Solid and Hematological Malignancies"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9533-6951","authenticated-orcid":false,"given":"Kalliopi","family":"Keramida","sequence":"first","affiliation":[{"name":"Cardiology Department, General Anti-Cancer Oncological Hospital Agios Savvas, 11522 Athens, Greece"},{"name":"Department of Cardiology, Athens University Hospital Attikon, Medical School, National and Kapodistrian University of Athens, 12462 Athens, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marianne C.","family":"Aznar","sequence":"additional","affiliation":[{"name":"Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-1380","authenticated-orcid":false,"given":"Jutta","family":"Bergler-Klein","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9820-4815","authenticated-orcid":false,"given":"Giuseppe","family":"Boriani","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Biomedical, Metabolic and Neural Sciences, Modena University Hospital, University of Modena and Reggio Emilia, 41121 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4038-8033","authenticated-orcid":false,"given":"Daniela","family":"Cardinale","sequence":"additional","affiliation":[{"name":"Cardioncology Unit, European Institute of Oncology, Istituto di Ricovero e Cura a Carattere Scientifico, Via Ripamonti 435, 20141 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan","family":"Dent","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Rochester, Rochester, NY 14627, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8865-3548","authenticated-orcid":false,"given":"Alexandra","family":"Drakaki","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5970-629X","authenticated-orcid":false,"given":"Jose J.","family":"Fuster","sequence":"additional","affiliation":[{"name":"Centro Nacional de Investigaciones Cardiovasculares (CNIC), 28029 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de Enfermedades Cardiovasculares, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamas A.","family":"Mamas","sequence":"additional","affiliation":[{"name":"Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent ST5 5BG, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tochi","family":"Okwuosa","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lydia","family":"Scarfo","sequence":"additional","affiliation":[{"name":"Universit\u00e0 Vita Salute San Raffaele, 20132 Milano, Italy"},{"name":"Strategic Research Program on CLL, IRCCS Ospedale San Raffaele, 20132 Milano, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Van Der Meer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University Medical Center Groningen, University of Groningen, 9712 Groningen, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4889-7454","authenticated-orcid":false,"given":"Eric H.","family":"Yang","sequence":"additional","affiliation":[{"name":"UCLA Cardio-Oncology Program, Division of Cardiology, Department of Medicine, University of California at Los Angeles, Los Angeles, CA 90095, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Lopez-Fernandez","sequence":"additional","affiliation":[{"name":"Cardio-Oncology Unit, Cardiology Department, IdiPAZ Research Institute, La Paz University Hospital, 28046 Madrid, Spain"},{"name":"Cardio-Oncology Unit, Cardiology Department, Quironsalud University Hospital, 28223 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,22]]},"reference":[{"key":"ref_1","first-page":"436","article-title":"Why sex and gender matter in cancer research and care","volume":"38","year":"2025","journal-title":"Klin. 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