Does SGLT2 inhibitors reduce all-cause mortality and heart failure outcomes in adult patients with cancer?
Adult patients (>18 years) with cancer
Sodium-glucose cotransporter-2 inhibitors (SGLT2i)
All-cause mortality and an HF composite (new-onset HF and/or HF hospitalization)composite
In adult cancer patients, SGLT2 inhibitors appear safe and may be associated with reduced mortality and heart failure events, though randomized trials are needed to confirm these findings.
BACKGROUND: According to available evidence, sodium-glucose cotransporter-2 inhibitors (SGLT2i) may confer cardioprotection in patients with cancer undergoing chemotherapy. OBJECTIVES: The objective of the study was to evaluate the impact of SGLT2i on all-cause mortality and heart failure (HF) outcomes in this population. METHODS: We searched PubMed, Cochrane CENTRAL, and Embase through August 2025 for studies of SGLT2i in adult patients with cancer. Random-effects models were used to pool effects for all-cause mortality and an HF composite (new-onset HF and/or HF hospitalization) in cancer patients >18 years. Meta-regression tested effect modification by beta-blockers, statins, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, age, and sex. RESULTS: = 66.4%; P < 0.001). Safety outcomes were not increased in the SGLT2i arm. CONCLUSIONS: In patients with cancer, SGLT2i appear safe and are associated with fewer deaths and HF events, although substantial heterogeneity was observed across studies. Randomized controlled trials are warranted to confirm these hypothesis-generating findings.
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Luigi Spadafora
Marco Bernardi
Gianmarco Sarto
JACC Advances
Sorbonne Université
University of Virginia
University of Milan
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Spadafora et al. (Fri,) studied this question.
www.synapsesocial.com/papers/6a095b787880e6d24efe1364 — DOI: https://doi.org/10.1016/j.jacadv.2026.102790