Key result
Beta-blockers preserve LVEF by ~3 percentage points vs standard care during anthracycline chemotherapy.
Why the study?
Anthracycline-induced cardiotoxicity is a significant complication in breast cancer patients receiving systemic therapy, and effective preventive strategies are limited.
Does beta-blocker therapy prevent the reduction of left ventricular ejection fraction in breast cancer patients receiving anthracyclines?
Meta-Analysis (n=772)
Does beta-blocker therapy prevent the reduction of left ventricular ejection fraction in breast cancer patients receiving anthracyclines?
Mean Difference: 2.85 (95% CI 0.58–5.12)
p-value: p=0.02
Beta-blocker therapy provides a modest but statistically significant preservation of left ventricular systolic function in breast cancer patients undergoing anthracycline-based chemotherapy.
Supports beta-blocker consideration for LVEF preservation in anthracycline-treated breast cancer; extends 8-RCT meta-analysis while leaving clinical impact open pending larger trials.
Purpose Anthracycline-induced cardiotoxicity remains an important complication in patients with breast cancer receiving systemic therapy, and effective preventive strategies remain limited. We conducted a systematic review and meta-analysis to evaluate the cardioprotective effects of beta-blockers in anthracycline-treated breast cancer patients. Methods Following PRISMA guidelines, Pubmed, Web of Science, CINAHL, and Cochrane were systematically searched, and the protocol was preregistered on PROSPERO (CRD420261366946). The primary outcome was left ventricular ejection fraction (LVEF), while the secondary outcome was E/A ratio. Certainty and robustness of the evidence were assessed using GRADE approach and trial sequential analysis (TSA). A meta-analysis was performed using R version 4.6.0, and heterogeneity was assessed using I 2 statistics. Results A total of 8 studies including 772 patients were analyzed. Beta-blocker therapy was associated with significant preservation of LVEF vs. placebo or standard care (MD, 2.85; 95% CI, 0.58–5.12; p = 0.02; I 2 95%). No significant improvement was observed for E/A ratio (MD, 0.10; 95% CI, −0.12 to 0.31; p = 0.25; I 2 69.7%). However, sensitivity analysis resulted in a statistically significant pooled effect (MD = 0.16, 95% CI: 0.03 to 0.29, p = 0.01; I 2 = 35.9%). TSA showed that the Z-curve crossed the monitoring boundaries favoring beta-blockers for LVEF; however, the required information size (RIS = 1,785) was not reached. Conclusion Beta-blockers were associated with preservation of systolic function in anthracycline-treated breast cancer patients. However, no significant benefit was observed for E/A ratio, and evidence regarding diastolic protection remains inconclusive. Larger, high-quality RCTs are needed to confirm these findings. Systematic Review Registration identifier CRD420261366946.
No takes yet. Share an insight, caveat, or question.
Samperio et al. (2026) conducted a meta-analysis in Breast cancer (n=772). Beta-blockers vs. Placebo or standard care was evaluated on Left ventricular ejection fraction (LVEF) (MD 2.85, 95% CI 0.58-5.12, p=0.02). Beta-blocker therapy significantly preserved left ventricular ejection fraction by a mean difference of 2.85 percentage points compared to placebo or standard care in anthracycline-treated breast cancer patients.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: