Abstract
In recent years, novel cancer therapies have significantly improved patient survival, but they have also introduced clinical challenges, particularly regarding treatment-related cardiovascular toxicity. Frailty is a clinical syndrome characterised by reduced physiological reserve, and is associated with poorer clinical outcomes and an elevated risk of cardiovascular disease. While it is more prevalent among older adults, frailty can also affect cancer patients due to shared pathophysiological mechanisms, such as mitochondrial dysfunction, chronic inflammation and oxidative stress, which may contribute to cancer therapy-induced cardiac damage. However, evidence supporting frailty as a predictive factor for cardiovascular complications in the cardio-oncology setting remains limited. This review emphasises the importance of incorporating frailty assessment into the oncological setting to improve risk stratification and guide personalised therapeutic strategies.