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Life sciences · Journal article
Cardio-oncology · September 29, 2026
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Cardiotoxicity remains a key concern of HER2-directed therapies, with no proven prevention strategies. The success of cardioprotective interventions will depend not only on efficacy, but on patient acceptability, an underexplored determinant of trial participation and clinical implementation. To evaluate willingness to take cardioprotective medication and identify factors influencing decision-making among individuals with HER2-positive breast cancer. We conducted a cross-sectional online survey of adults with HER2-positive breast cancer in Australia and the United States. The survey assessed willingness, beliefs regarding benefits and risks, and treatment preferences. Multivariable logistic regression examined associations between clinical and demographic characteristics and willingness. Among 74 respondents (Australia n = 24; United States [US] n = 50), 74.3% reported being likely or very likely to take cardioprotective medication. Among US respondents, physician recommendation emerged as a dominant driver (79.1%). Most of these respondents valued long-term cardiovascular health (72.9%) and many indicated that they would require stronger evidence before initiating cardioprotective medication (60.4%). Cancer-related outcomes were prioritized over cardiovascular outcomes. Respondents demonstrated flexibility regarding treatment burden, including willingness to take multiple medications and continue therapy long-term. No demographic or clinical predictors of willingness were identified. Among US respondents, perceived acceptability, appropriateness, and feasibility were generally favorable. Willingness to adopt cardioprotective strategies was conditional, shaped by cancer priorities, clinician recommendation, and uncertainty regarding benefit. These findings highlight the importance of incorporating patient perspectives into the design of cardioprotection trials and future implementation strategies in cardio-oncology.