A systematic review and meta-analysis of beta-blockers and renin–angiotensin system inhibitors for preventing left ventricular dysfunction due to anthracyclines or trastuzumab in patients with breast cancer
Why the study?
Trastuzumab and anthracyclines used in breast cancer can cause myocardial dysfunction and reduce LVEF, and RCTs evaluating BBs and ACEI/ARBs for preventing this cardiotoxicity had not been synthesized.
Do beta-blockers and ACEI/ARBs prevent left ventricular dysfunction in women with breast cancer treated with anthracyclines or trastuzumab?
Comparison
BBs or ACEI/ARBs vs placebo
Design
Systematic review and meta-analysis of RCTs
Authors
Discussion
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Member takes
Implication
Supports beta-blockers and ACEI/ARBs to preserve LVEF with trastuzumab; extends meta-analytic evidence for selective cardioprotection in breast cancer.
Structured PICO
Do beta-blockers and ACEI/ARBs prevent left ventricular dysfunction in women with breast cancer treated with anthracyclines or trastuzumab?
P
Population
1,362 women with breast cancer treated with either trastuzumab or anthracyclines (pooled from 9 RCTs)
I
Intervention
Beta-blockers (BBs) or angiotensin-converting enzyme inhibitors (ACEI) / angiotensin receptor blockers (ARBs)
C
Comparator
Placebo
O
Outcome
Mean difference in left ventricular ejection fraction (LVEF) between intervention and placebo groups at follow-upsurrogate
Beta-blockers and ACEI/ARBs help preserve left ventricular ejection fraction in women receiving cardiotoxic breast cancer treatments, particularly trastuzumab.
Cite This Study
Lewinter et al. (2021) studied this question.