Gaps in Onco-Cardiology Practice and Educational Needs for the Next Generation of Pharmacists in Japan.

Background: Cancer therapy-related cardiovascular toxicity is increasingly recognized as a major issue in cancer care, underscoring the need for multidisciplinary onco-cardiology. Although pharmacists are expected to play important roles in this field, their real-world involvement and challenges in onco-cardiology practice in Japan remain unclear. Methods and Results: We conducted a cross-sectional web-based survey of early career pharmacists (aged ≤45 years) in Japan between July and August, 2025. The questionnaire assessed pharmacists' background, awareness of onco-cardiology and related clinical guidelines, areas of interest, clinical experience, perceived challenges, interprofessional collaboration, and educational needs. A total of 105 pharmacists responded. Approximately 80% of respondents reported moderate to high interest in onco-cardiology. However, clinical experience in onco-cardiology was limited; 56.2% of respondents managed only 1-5 cases per month, and 20.0% reported no prior experience. Collaboration scores differed significantly across domains, with hospital pharmacy-community pharmacy collaboration being significantly lower than collaboration between pharmacists and oncologists or cardiologists (P<0.001). Major challenges included insufficient knowledge, limited educational opportunities, and difficulties in multidisciplinary collaboration. Conclusions: Although early career pharmacists participating in this study demonstrate strong interest in onco-cardiology, their clinical involvement remains limited, and interprofessional collaboration is suboptimal. Structured educational programs and strengthened collaboration frameworks, particularly between hospital and community pharmacy settings, are needed to facilitate pharmacists' integration into multidisciplinary onco-cardiology care.