Publication Name	World Journal of Cardiology
Manuscript ID	126635
DOI	10.4330/wjc.126635
Country	Algeria

Category	Cardiac & Cardiovascular Systems
Manuscript Type	Minireviews
Article Title	Trial architecture in contemporary cardio-oncology: Why parallel-group randomized controlled trials may not fit every cardiotoxicity phenotype
Manuscript Source	Invited Manuscript
All Author List	Radhia Chems Telli
Funding Agency and Grant Number
Corresponding Author	Radhia Chems Telli, Researcher, Department of Medicine, University of Biskra, B.P. 145, RP, Biskra 07000, Algeria. radhia.telli@univ-biskra.dz
Key Words	Cardio-oncology; Cardiotoxicity; Cardioprotection; Clinical trial design; Adaptive clinical trials; Biomarker-enriched trial design; Master protocols; Registry-based randomized trial; Immune checkpoint inhibitor myocarditis; Cancer therapy-related cardiovascular toxicity
Core Tip	This minireview is concerned with how cardioprotection trials are designed, not with the pharmacological efficacy of any particular cardioprotective agent. These trials have relied almost exclusively on the conventional parallel-group randomized controlled trial, regardless of which cardiotoxicity phenotype is studied. This minireview maps six contemporary phenotypes – from anthracycline-related left ventricular dysfunction to radiation-induced cardiovascular disease – against established trial-design principles (biomarker-enriched, adaptive, master-protocol, and registry-embedded designs) already used elsewhere in medicine. Only anthracycline-related left ventricular dysfunction is currently supported by conducted trials using an alternative architecture; the remaining five phenotypes require prospective evaluation of untested conceptual directions.
Citation	Telli RC. Trial architecture in contemporary cardio-oncology: Why parallel-group randomized controlled trials may not fit every cardiotoxicity phenotype. World J Cardiol 2026; In press DOI: https://doi.org/10.4330/wjc.126635
PDF	126635-in-press.pdf

Received	2026-08-10 08:04
Peer-Review Started	2026-08-10 08:04
First Decision by Editorial Office Director
Return for Revision	2026-09-20 03:16
Revised	2026-10-01 13:59
Publication Fee Transferred
Second Decision by Editor	2026-10-28 07:35
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-10-28 10:27
Articles in Press	2026-10-28 10:27
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1949-8462 (online)
Open Access	This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution-NonCommercial (CC BY-NC 4.0) license. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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