Key result
Neurohormonal modulation cuts anthracycline-induced cardiac dysfunction by ~55% in breast cancer patients.
Why the study?
Anthracycline-induced cardiac dysfunction remains a significant complication for breast cancer patients, and the effectiveness of neurohormonal modulation for its prevention remains uncertain.
Does neurohormonal modulation reduce the incidence of anthracycline-induced cardiac dysfunction in breast cancer patients receiving anthracyclines?
Meta-Analysis (n=1,821)
Does neurohormonal modulation reduce the incidence of anthracycline-induced cardiac dysfunction in breast cancer patients receiving anthracyclines?
Neurohormonal modulation with renin-angiotensin system inhibitors or beta-blockers significantly reduces the incidence of anthracycline-induced cardiac dysfunction and preserves LVEF in breast cancer patients.
May support prophylactic RAS inhibitors or beta-blockers to reduce AICD risk in breast cancer; extends HF neurohormonal evidence to cardio-oncology prevention.
Background and Aims Anthracycline-induced cardiac dysfunction (AICD) is cardiac injury associated with potentially cardiotoxic anthracycline therapy, and remains a significant complication for breast cancer patients. Neurohormonal modulation, a therapeutic strategy used primarily in heart failure, including renin–angiotensin system inhibitors and beta-blockers, has been proposed to prevent AICD. Several trials have reported potential cardioprotective benefits, but effectiveness remains uncertain. Therefore, we aimed to evaluate the effect of neurohormonal modulation on AICD incidence and left ventricular ejection fraction (LVEF) in patients receiving anthracycline. Methods A comprehensive literature search was conducted to identify randomised controlled trials (RCTs) investigating the cardioprotective effect of neurohormonal modulation therapy in patients administered with anthracyclines. The primary outcome was AICD incidence, and the secondary outcome was change in LVEF from baseline to the end of study. The meta-analysis was conducted using RevMan with a random-effects model. Results Fourteen RCTs involving 1,821 patients were included. Neurohormonal modulation was associated with significant reduction in the incidence of AICD (risk ratio [RR] 0.45, 95% confidence interval [CI] 0.31–0.67; p<0.0001; I²=60%). Subgroup analyses demonstrated consistent benefit with renin–angiotensin system inhibitors (RR 0.39, 95% CI 0.22–0.69) and beta-blockers (RR 0.53, 95% CI: 0.28–0.99). Neurohormonal modulation therapy also demonstrated preservation of LVEF (mean difference [MD] 2.09%, 95% CI 1.44–2.74; p<0.00001; I²=87%). Conclusion Neurohormonal modulation significantly reduces the incidence of AICD and preserves LVEF in breast cancer patients receiving anthracycline-based chemotherapy, supporting its role as a cardioprotective strategy.
No takes yet. Share an insight, caveat, or question.
Sidabukke et al. (2026) conducted a meta-analysis in Anthracycline-induced cardiac dysfunction in breast cancer patients (n=1,821). Neurohormonal modulation vs. Control was evaluated on Incidence of anthracycline-induced cardiac dysfunction (AICD) (RR 0.45, 95% CI 0.31-0.67, p=<0.0001). Neurohormonal modulation significantly reduced the incidence of anthracycline-induced cardiac dysfunction (RR 0.45; 95% CI 0.31-0.67; p<0.0001) in breast cancer patients receiving anthracyclines.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: