Cardiac Toxicities in Oncology: Elucidating the Dark Box in the Era of Precision Medicine

Round 1

Reviewer 1 Report

This narrative review on cardio-oncology describes in detail the common
cardio-toxicities observed in patients post anti-cancer treatment, the
effects of immunotherapies against cancer in the heart, the clinical
management of cardio-oncology related cardio-toxicities, and the preventive
counter measures that could be applied to protect the heart when such
therapeutic approaches applied. In 2020 a special report was published
(ref#112) on the pragmatic approach to cardio-oncology by the American and
European cardio-oncology related societies. However, there are not any
specific recommendations for the molecular monitoring that could be applied
in prevention of cardio-toxicities. This interesting review of the existing
literature summarizes these particularly important topics for all cardiologists,
oncologists, and molecular biologists.

Author Response

Dear Editor and Reviewers,

I am pleased to resubmit for publication the revised version of cimb-2668944 manuscript, entitled “Cardiac Toxicities in Oncology: Elucidating The Dark Box in the Era of Precision Medicine”.

Thankfully the reviewers provided us with a great deal of guidance, regarding how to better position the article. We are hopeful you agree that this revision will update our comprehensive review. All the comments have been addressed, as shown in the revised version of the manuscript, along with this point-by-point response to the reviewers' comments.

All corresponding are blue changes in the manuscript.

Reviewer #1:

• General comments:

“This narrative review on cardio-oncology describes in detail the common cardio-toxicities observed in patients post anti-cancer treatment, the effects of immunotherapies against cancer in the heart, the clinical management of cardio-oncology related cardio-toxicities, and the preventive counter measures that could be applied to protect the heart when such therapeutic approaches applied. In 2020 a special report was published (ref#112) on the pragmatic approach to cardio-oncology by the American and European cardio-oncology related societies. However, there are not any specific recommendations for the molecular monitoring that could be applied in prevention of cardio-toxicities. This interesting review of the existing literature summarizes these particularly important topics for all cardiologists, oncologists, and molecular biologists.”.

Response:

Thank you for your positive reinforcement. We appreciate the opportunity to revise our work for consideration for publication.

Reviewer 2 Report

Comments

The manuscript title “Cardiac Toxicities in Oncology: Elucidating The Dark Box in 2 the Era of Precision Medicine” is interesting and its comes in the journal scope.  There are few suggestion if authors add it looks more informative and attractive, the details are as under

1.       Authors should add material and methods sections where it should be mentioned about the selection criteria, search, data collection and analysis, and study quality and risk of bias.

2.       Authors should add the mechanistic approach as a figure of important markers such as microRNA, (MPO), Galectin-3,and GDF-15.

3.       Add the figure for Identification of high-risk populations

4.        Line no 565 to 567 re write the sentences.

5.       Table 2 is needed to reorganize to avoid the confusion.

6.       Change the text referencing from small brackets () to big brackets [ ] in the whole manuscript.

7.       Author’s contribution section carefully checks and distributes the work accordingly.

Author Response

Dear Editor and Reviewers,

I am pleased to resubmit for publication the revised version of cimb-2668944 manuscript, entitled “Cardiac Toxicities in Oncology: Elucidating The Dark Box in the Era of Precision Medicine”.

Thankfully the reviewers provided us with a great deal of guidance, regarding how to better position the article. We are hopeful you agree that this revision will update our comprehensive review. All the comments have been addressed, as shown in the revised version of the manuscript, along with this point-by-point response to the reviewers' comments.

All corresponding are blue changes in the manuscript.

Reviewer #2:

• General comments:

“The manuscript title “Cardiac Toxicities in Oncology: Elucidating The Dark Box in 2 the Era of Precision Medicine” is interesting and its comes in the journal scope. There are few suggestion if authors add it looks more informative and attractive, the details are as under”.

Response:

We appreciate you taking the time to offer us your comments and insights related to the paper. Thank you for your positive reinforcement and constructive feedback. We tried to be responsive to your concerns as we approached our revision.

• Major comments:

1. Authors should add material and methods sections where it should be mentioned about the selection criteria, search, data collection and analysis, and study quality and risk of bias.

Response:

Thank you for your valuable recommendation. We have now added the section “Methods” in the revised manuscript (Lines 78-93).

2. Authors should add the mechanistic approach as a figure of important markers such as microRNA, (MPO), Galectin-3,and GDF-15.

Response:

Thank you for your suggestion. We have now included figure 1 along with its caption in the revised manuscript (Lines 576-589).

3. Add the figure for Identification of high-risk populations.

Response:

Thank you for your recommendation. We have now included figure 2 along with its caption in the revised manuscript (Lines 636-637 and 664-671).

4. Line no 565 to 567 re write the sentences.

Response:

Thank you for that comment. We have now rephrased this sentence in the revised manuscript (Lines 609-612).

5. Table 2 is needed to reorganize to avoid the confusion.

Response:

Thank you for raising this concern. We kindly request your agreement to retain the current table format. We firmly believe that presenting the entire table on a single page in a formal layout will enhance clarity and visual appeal for the readers.

6. Change the text referencing from small brackets () to big brackets [ ] in the whole manuscript.

Response:

Thank you for your comment. We changed the text referencing from small to big brackets through the manuscript, according to the styling of the journal.

7. Author’s contribution section carefully checks and distributes the work accordingly.

Response:

Thank you for your suggestion. We have double checked and confirmed.