Why the study?
Breast cancer therapeutics cause cardiotoxicity that limits their use, prompting an evaluation of whether nutritional interventions with antioxidant and anti-inflammatory properties can modulate this risk.
Do nutritional interventions modulate chemotherapy-induced cardiotoxicity in women with breast cancer?
Systematic Review (n=484)
Do nutritional interventions modulate chemotherapy-induced cardiotoxicity in women with breast cancer?
Appropriate nutritional interventions, such as oral antioxidant supplementation, may attenuate the risk of chemotherapy-induced cardiotoxicity and preserve cardiac function in breast cancer patients.
May support nutritional adjuncts to limit LVEF decline during breast cancer chemotherapy; extends low-certainty evidence but requires RCTs before practice change.
BACKGROUND/OBJECTIVES: Advancements in breast cancer therapeutics, such as anthracyclines, are improving cancer survival rates but can have side effects that limit their use. Cardiotoxicity, defined as damage to the heart caused by cancer therapeutics, is characterised by a significant reduction in left ventricular ejection fraction (LVEF) and symptoms of cardiac dysfunction. Multiple oral supplements exist with antioxidant and anti-inflammatory properties that have the potential to lower cardiotoxicity risk and ameliorate the complications associated with left ventricular dysfunction. In this review, we evaluate the current status of using nutritional interventions to modulate cardiotoxicity. METHODS: We used specific keywords to search for articles that met our predetermined inclusion and exclusion criteria to review the evidence and provide insights for future research. RESULTS: Seven studies were identified as eligible for this review: six focused on oral supplementation strategies in breast cancer patients undergoing chemotherapy, and one focused on nutritional counselling and adherence to the Mediterranean diet in breast cancer survivors' post-treatment. There was a significantly attenuated reduction in LVEF in five studies that monitored cardiometabolic health, and there were significant improvements in blood serum levels of cardiac biomarkers across all studies. CONCLUSIONS: Current evidence suggests that appropriate nutritional interventions, alongside chemotherapy, can modulate the risk of cardiotoxic side effects. This highlights the potential of oral antioxidant supplementation and Mediterranean diet counselling to decrease tertiary cancer therapy costs associated with cardiovascular complications.
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Stephenson et al. (2024) conducted a systematic review in Breast cancer undergoing or post-chemotherapy (n=484). Nutritional interventions (oral antioxidant supplementation or Mediterranean diet) vs. Standard care or placebo was evaluated on Changes in left ventricular ejection fraction (LVEF) and cardiac biomarkers.
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