Key result
Sacubitril/valsartan cuts cancer therapy-related cardiac dysfunction risk ~34% vs. control.
Why the study?
Sacubitril/valsartan is under investigation for cardiac protection during cancer therapy, but evidence regarding its preventive effect on cancer therapy–related cardiac dysfunction remains inconsistent.
Does sacubitril/valsartan reduce cancer therapy-related cardiac dysfunction in patients with preserved baseline cardiac function receiving oncologic therapy?
Meta-Analysis (n=410)
Does sacubitril/valsartan reduce cancer therapy-related cardiac dysfunction in patients with preserved baseline cardiac function receiving oncologic therapy?
Effect estimate: RR 0.66 (95% CI 0.53 to 0.82)
p-value: p=< 0.001
Sacubitril/valsartan may modestly reduce the risk of cancer therapy-related cardiac dysfunction and attenuate LVEF/GLS decline, but current evidence is insufficient to change clinical practice.
Offers a cardioprotective strategy during oncologic therapy at the cost of increased.
Sacubitril/valsartan is being investigated for cardiac protection during cancer therapy. However, evidence regarding its preventive effect on cancer therapy–related cardiac dysfunction (CTRCD) remains inconsistent. To evaluate the efficacy and safety of sacubitril/valsartan for the prevention of CTRCD during oncologic therapy. We searched PubMed, EMBASE, and Web of Science for randomized controlled trials (RCTs) comparing sacubitril/valsartan with control for the prevention of CTRCD during oncologic therapy, with treatment effects synthesized using risk ratio (RR), mean differences (MD), or standardized mean differences (SMD) with 95% confidence intervals. Four RCTs involving 410 participants were included. Sacubitril/valsartan reduced the absolute risk of CTRCD compared with control (RR 0.66, 95% CI 0.53 to 0.82, p < 0.001). Sacubitril/valsartan was associated with a significant improvement in left ventricular ejection fraction (MD 1.19%, 95% CI 0.05 to 2.33, p = 0.045), global longitudinal strain (SMD 0.43, 95% CI 0.10 to 0.75, p = 0.026), and a reduction in troponin (log-MD − 0.43, 95% CI − 0.59 to − 0.26, p < 0.001), compared with the control group. Sacubitril/valsartan increased the risk of hypotension (RR 4.75, 95% CI 1.78 to 12.63, p = 0.002). No significant differences were observed in left ventricular volume, work indices, or NT-proBNP levels. Trial sequential analysis indicated that the current evidence remains insufficient to draw firm conclusions regarding the effect of cardioprotection on CTRCD. Sacubitril/valsartan may be associated with modest reductions in CTRCD risk and attenuation of LVEF and GLS decline in patients with preserved baseline cardiac function receiving chemotherapy. However, the clinical relevance remains inconclusive when considering the trial sequential analysis and the modest magnitude of effect. These findings are primarily hypothesis-generating rather than practice-changing, and require confirmation in larger randomized trials, particularly in higher-risk populations.
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Wu et al. (2026) conducted a meta-analysis in Cancer therapy-related cardiac dysfunction (n=410). Sacubitril/valsartan vs. Control/Standard care was evaluated on Cancer therapy-related cardiac dysfunction (CTRCD) (RR 0.66, 95% CI 0.53 to 0.82, p=< 0.001). Sacubitril/valsartan reduced the risk of cancer therapy-related cardiac dysfunction compared with control (RR 0.66).
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