The role of cardio-protective agents in cardio-preservation in breast cancer patients receiving Anthracyclines ± Trastuzumab: a Meta-analysis of clinical studies

Elghazawy, Hagar; Venkatesulu, Bhanu Prasad; Verma, Vivek; Pushparaji, Bala; Monlezun, Dominique; Marmagkiolis, Konstantinos; Iliescu, Cezar

doi:10.1016/j.critrevonc.2020.103006

Cited by 17 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Other strategies, such as exercise-based cardiac rehabilitation during chemotherapy, should be implemented as well to prevent cardiotoxicity. 15 …”

Section: Discussionmentioning

confidence: 99%

“…A subsequent meta-analysis of 22 prospective studies, including 2302 participants receiving anthracyclines with or without trastuzumab, assessed endpoints at the end of chemotherapy, at 6 months and 1 year. 15 In the 16 studies that tested the protective effects of neurohormonal therapy at the end of chemotherapy, there was a significant difference in the mean change in FE (−2.36) in patients receiving cardioprotective drugs compared to controls ( P < 0.00001) and the benefits were confirmed at 6 months and 1 year. However, no cardioprotective effect was observed on volumes.…”

Section: Clinical Studiesmentioning

confidence: 97%

See 1 more Smart Citation

Prevention of chemotherapy-induced left ventricular dysfunction

Bisceglia

Canale

Cartoni

et al. 2021

European Heart Journal Supplements

View full text Add to dashboard Cite

Prevention of left ventricular dysfunction predominantly induced by anthracyclines and/or trastuzumab still represents a challenge for cardio-oncology today. Indeed, this complication threatens to limit the significant gain in cancer survival achieved to date. Oncology strategies with cumulative dose limitation, continuous infusion, dexrazoxane, and liposomal formulations have been shown to decrease the risk of anthracycline cardiotoxicity. The preventive use of ace inhibitors, sartans, and/or beta-blockers has not yet provided convincing evidence and the positive effect on left ventricular ejection fraction decline appears poor without a clear clinical relevance. Assessment of the cardiovascular risk profile is a key aspect of the baseline evaluation of any patient scheduled for cancer therapy. Control and/or correction of modifiable cardiovascular risk factors is the first form of primary prevention of cardiotoxicity. It will be necessary to select populations at higher risk of developing cardiac dysfunction, identify patients genetically predisposed to develop cardiotoxicity in order to build the most appropriate strategies to correctly and timely target cardioprotective therapies.

show abstract

“…Other strategies, such as exercise-based cardiac rehabilitation during chemotherapy, should be implemented as well to prevent cardiotoxicity. 15 …”

Section: Discussionmentioning

confidence: 99%

Section: Clinical Studiesmentioning

confidence: 97%

Prevention of chemotherapy-induced left ventricular dysfunction

Bisceglia

Canale

Cartoni

et al. 2021

European Heart Journal Supplements

View full text Add to dashboard Cite

show abstract

“…Recently, a meta-analysis reported on the available evidence about primary prevention with renin-angiotensin-aldosterone inhibitors such as ACEI and ARB, and beta-blockers, in breast cancer patients treated with anthracyclines with and without trastuzumab [ 28 ]. A total of N = 2301 patients was included, and the cardioprotective effect of the different drugs was estimated.…”

Section: Review / Main Textmentioning

confidence: 99%

Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer

et al. 2021

View full text Add to dashboard Cite

Background Cancer treatment-related morbidity relevantly compromises health status in cancer survivors, and efforts to optimise health-related outcomes in this population are vital to maximising healthy survivorship. A pre-treatment assessment – and possibly preventive management strategies – of cancer patients at increased risk for cardiovascular disease (CVD) seems a rational approach in this regard. Definitive evidence for such strategies is largely lacking, thereby impeding the formulation of firm recommendations. Results The current scoping review aims to summarise and grade the evidence regarding strategies for prediction and prevention of CVD in adults in relation to oncological treatments. We conducted a scoping literature search for different strategies for primary prevention, such as medical and lifestyle interventions, as well as the use of predictive risk scores. We identified studies with moderate to good strength and up to now limited evidence to recommend primary preventive strategies in unselected patients treated with potentially cardiotoxic oncologic therapies. Conclusion Efforts to minimize the CVD burden in cancer survivors are needed to accomplish healthy survivorship. This can be done by means of robust models predictive for CVD events or application of interventions during or after oncological treatments. Up to now there is insufficient evidence to implement preventive strategies in an unselected group of patients treated with potential cardiotoxic oncological treatments. We conclude that randomised controlled trials are needed that evaluate medical and lifestyle interventions in groups at increased risk for complications, in order to be able to influence chronic illness risks, such as cardiovascular complications, for cancer survivors.

show abstract

“…ACEI/ARB can change the neurohumoral renin-angiotensin-aldosterone system (RAAS) pathway and prevent heart remodelling. Beta-blockers reduce sympathetic dysfunction ( Elghazawy et al, 2020 ). However, metoprolol had no effect on the overall decline in LVEF ( Gulati et al, 2016 ).…”

Section: Preventive Measuresmentioning

confidence: 99%

Cardiotoxicity of Epidermal Growth Factor Receptor 2-Targeted Drugs for Breast Cancer

Yang¹,

Wang²,

Wang³

et al. 2021

Front. Pharmacol.

View full text Add to dashboard Cite

Breast cancer is the most common form of cancer in women and its incidence has been increasing over the years. Human epidermal growth factor receptor 2 (HER2 or ErbB2) overexpression is responsible for 20 to 25% of invasive breast cancers, and is associated with poor prognosis. HER2-targeted therapy has significantly improved overall survival rates in patients with HER2-positive breast cancer. However, despite the benefits of this therapy, its cardiotoxicity is a major concern, especially when HER2-targeted therapy is used in conjunction with anthracyclines. At present, the mechanism of this cardiotoxicity is not fully understood. It is thought that HER2-targeting drugs inhibit HER2/NRG 1 dimer formation, causing an increase in ROS in the mitochondria of cardiomyocytes and inhibiting the PI3K/Akt and Ras/MAPK pathways, resulting in cell apoptosis. Antioxidants, ACE inhibitors, angiotensin II receptor blockers, β-blockers, statins and other drugs may have a cardioprotective effect when used with ErbB2-targeting drugs. NT-proBNP can be used to monitor trastuzumab-induced cardiotoxicity during HER2-targeted treatment and may serve as a biological marker for clinical prediction of cardiotoxicity. Measuring NT-proBNP is non-invasive, inexpensive and reproducible, therefore is worthy of the attention of clinicians. The aim of this review is to discuss the potential mechanisms, clinical features, diagnostic strategies, and intervention strategies related to cardiotoxicity of ErbB2-targeting drugs.

show abstract

The role of cardio-protective agents in cardio-preservation in breast cancer patients receiving Anthracyclines ± Trastuzumab: a Meta-analysis of clinical studies

Cited by 17 publications

References 24 publications

Prevention of chemotherapy-induced left ventricular dysfunction

Prevention of chemotherapy-induced left ventricular dysfunction

Evidence-based prediction and prevention of cardiovascular morbidity in adults treated for cancer

Cardiotoxicity of Epidermal Growth Factor Receptor 2-Targeted Drugs for Breast Cancer

Contact Info

Product

Resources

About