Audio Summary of three articles from the October 2026 issue of JACC: Advances.

Commentary by Dr. Yoriyasu Suzuki.

Commentary by Dr. Junjie Yang.

Commentary by Dr. Qinkai Yu.

Editor-in-Chief Dr. Bonnie Ky introduces the October 2026 issue of JACC: CardioOncology, featuring Part 1 of a special focus on immunology and cardio-oncology. This issue brings together state-of-the-art reviews, primers, original research, and clinical cases examining the immune system's central role in cancer and cardiovascular disease. Topics include the mechanisms and clinical implications of cancer immunotherapies and the immune system's contributions to the cardiovascular effects of cytotoxic chemotherapy, with implications for scientific discovery and patient care.

Dr. Caitlin O'Meara discusses a JACC: CardioOncology study showing that doxorubicin reprograms CD8+ T cells into matrix-remodeling T cells (mxT-cells) that produce lysyl oxidase (LOX) and stiffen the cardiac extracellular matrix through HIF1α-P53-TGFβ signaling. She explains how this new immune mechanism of anthracycline cardiotoxicity could lead to therapies that prevent cardiac fibrosis, cardiomyopathy, and heart failure in patients treated with chemotherapy.

Dr. David Austin discusses a JACC: CardioOncology study showing that high-sensitivity cardiac troponin T was elevated in 37.9% of patients starting immune checkpoint inhibitor (ICI) therapy, compared with only 1.8% for high-sensitivity troponin I, a discordance linked to older age, male sex, and kidney dysfunction. He explains what this means for troponin assay selection, baseline testing, and ICI myocarditis surveillance, helping cardiologists and oncologists avoid unnecessary cancer treatment interruptions and immunosuppression.

Dr. Cristina Gil-Cruz discusses a JACC: CardioOncology study comparing early- and late-manifestation immune checkpoint inhibitor (ICI) myocarditis, where endomyocardial biopsies showed greater T-cell and macrophage infiltration in early cases despite similar left ventricular ejection fraction and fibrosis. She explains what these inflammatory cell profiles mean for cardio-oncology care, from immunosuppression and ICI rechallenge to balancing cardiac safety with effective cancer immunotherapy.