Cancerworld Magazine
  • About the Magazine
    • Editorial Team
    • Leadership and Management
    • Events
    • Magazine
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
    • Partnership
    • Supported contents
  • Media Corner
    • Journalist Cancer Guide
    • Cancer Journalism Award
    • Cancer Journalist Grant
SUBSCRIBE FOR FREE
Facebook
Twitter
LinkedIn
Cancerworld Magazine
Cancerworld Magazine
  • About the Magazine
    • Editorial Team
    • Leadership and Management
    • Events
    • Magazine
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
    • Partnership
    • Supported contents
  • Media Corner
    • Journalist Cancer Guide
    • Cancer Journalism Award
    • Cancer Journalist Grant
Cancerworld Magazine > News > ACE inhibitor protects against cardiotoxicity
  • News

ACE inhibitor protects against cardiotoxicity

  • 18 June 2021
  • Janet Fricker
ACE inhibitor protects against cardiotoxicity
Total
36
Shares
36
0
0
0
0

In HER2 breast cancer, concurrent use of the ACE inhibitor lisinopril with trastuzumab-anthracyclines benefits left ventricular ejection fraction (LVEF). The study, abstract 509, presented in a poster session at the ASCO meeting, June 4-8, found breast cancer patients treated with trastuzumab plus anthracyclines experienced greater LVEF adverse effects than those using trastuzumab alone.

Trastuzumab has been shown to be highly effective for treating HER2-postive breast cancer, comprising around 30% of all breast cancers. However, trastuzumab has also been associated with declines in LVEF, and diagnosis of clinical heart failure prompts interruption and discontinuation of treatment. In cardiology, angiotensin-converting enzyme (ACE) inhibitors and beta blockers are widely used to both prevent and treat heart failure. Several studies have demonstrated favourable effects of ACE inhibitors and beta blockers in the prevention of chemotherapy induced toxicity.

For the current study, Pamela Munster, a medical oncologist from the University of California, San Francisco, and colleagues, evaluated the preventive impact of the ACE inhibitor lisinopril and the beta blocker carvedilol on LVEF during trastuzumab and anthracycline treatment.
In the prospective randomised study, 468 women with early stage HER2 positive breast cancer undergoing neoadjuvant chemotherapy with trastuzumab were randomised to receive once daily lisinopril (10mg), carvedilol (10g) or placebo during one year of treatment. The patients, mean age 51 years, were further stratified according to anthracycline use (AC+T) versus non-anthracycline use (nonAC+T). Patients were recruited from 127 community-based oncology practices. Overall, in the AC+T group there were 188 women, of whom 65 received lisinopril, 61 carvedilol and 62 placebo. In the non-AC+T group there were 276 women, of whom 91 received lisinopril, 95 carvedilol, and 90 placebo.

Results show rates of LVEF decline to <50% occurred in 21% for patients treated with an anthracycline + trastuzumab (AC+T) vs 4.1% treated with trastuzumab alone (nonAC+T). In the AC+T group LVEF <50% occurred in 10.8% of those treated with lisinopril vs 30.5% treated with placebo (P=0.045). A smaller, but not significant benefit was seen for carvedilol.
The incidence of cardiotoxicity manifesting as LVEF decrease by ≥ 10% from normal was similar in both ACT+T and the nonAC+T arms, and unaffected by either lisinopril or carvedilol.
During trastuzumab therapy, a small but not clinically relevant decrease in LVEF was observed in all patients which was not significantly altered by either lisinopril or carvedilol. Lisinopril was shown to be tolerable even in patients without hypertension.

“In women treated in a community-based environment who will benefit from anthracyclines, or where anthracyclines are indicated, one should anticipate the decrease in left ventricular ejection fraction to below normal is larger than reported in other groups. However, this could be prevented by lisinopril,” concluded study presenter Pamela Munster.

The study, she added, suggests drops in LVEF to below 50%, which occurred in 21% (38) of patients taking anthracyclines, were much larger than previously reported.

Total
36
Shares
Share 36
Tweet 0
Share 0
Share 0
Share 0
Related Topics
  • ACE inhibitor
  • beta blocker
  • cardiotoxicity
  • carvedilol
  • HER2 breast cancer
  • left ventricular ejection fraction
  • lisinopril
  • trastuzumab
Janet Fricker

Janet Fricker is a medical writer specialising in oncology and cardiology. After researching articles for Cancerworld she runs, swims, and eats porridge.

Previous Article
  • News

Advance Care Planning increases hope

  • 18 June 2021
  • Janet Fricker
View Post
Next Article
  • Articles
  • Medicine

Innovations in supportive care: cancer treatment side effects

  • 18 June 2021
  • Rachel Brazil
View Post
You May Also Like
View Post
  • News

Study highlights need to reanalyse genomics and genetics of metastatic tumours

  • Janet Fricker
  • 27 January 2023
View Post
  • News

Current cervical cancer screening paradigm fails older women

  • Janet Fricker
  • 26 January 2023
View Post
  • News

Call-to-arms for Europe to provide essential paediatric anti-cancer medicines

  • Janet Fricker
  • 9 January 2023
View Post
  • News

Exercise-stimulated myokine production can extend survival in advanced prostate cancer

  • Janet Fricker
  • 9 January 2023
View Post
  • News

Five San Antonio take-aways to improve care of breast cancer patients

  • Janet Fricker
  • 16 December 2022
View Post
  • News

Repurposed drug combination reduces risk of recurrence following surgery for colorectal cancer

  • Janet Fricker
  • 16 December 2022
View Post
  • News

Aerobic activity to outcompete metastasis 

  • Janet Fricker
  • 2 December 2022
View Post
  • News

Ending cancer inequalities: European summit showcases new tools to inform policy

  • Anna Wagstaff
  • 30 November 2022

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

search
or search in Cancerworld archive
Newsletter

Subscribe free to
Cancerworld!

We'll keep you informed of the latest features and news with a fortnightly email

Subscribe now
Latest News
  • Study highlights need to reanalyse genomics and genetics of metastatic tumours
    • 27 January 2023
  • Current cervical cancer screening paradigm fails older women
    • 26 January 2023
  • Call-to-arms for Europe to provide essential paediatric anti-cancer medicines
    • 9 January 2023
  • Exercise-stimulated myokine production can extend survival in advanced prostate cancer
    • 9 January 2023
  • Five San Antonio take-aways to improve care of breast cancer patients
    • 16 December 2022
Article
  • The cancer patients still struggling to access drugs in the wake of anti-corruption reforms
    • 27 January 2023
  • Immunotherapy: outcomes of ultra low-dose trial offer hope for better global access
    • 26 January 2023
  • Cervical cancer elimination efforts boosted by simpler ways to identify and treat pre-cancerous lesions
    • 12 January 2023
Latest printed issue
Social

Would you follow us ?

Contents
  • Hansjörg Senn of St Gallen: A practice-changing career
    • 3 February 2023
  • AI in Genomics and Reporting for Clinical Practice
    • 26 January 2023
  • Telemedicine in Cancer Care: Monitoring, Follow-Up,Tele-Rehabilitation, Palliative and Supportive Care
    • 23 January 2023
MENU
  • About the Magazine
    • Editorial Team
    • Leadership and Management
    • Events
    • Magazine
    • Archive
    • Contacts
  • Articles
    • Policy
    • Practice Points
    • Delivery of Care
    • Biology basic
    • Medicine
    • Featured
  • Contents
    • News
    • Editorials
    • Interviews to the Expert
    • In the Hot Seat
    • Profiles
    • Obituaries
    • Voices
    • Partnership
    • Supported contents
  • Media Corner
    • Journalist Cancer Guide
    • Cancer Journalism Award
    • Cancer Journalist Grant
Cancerworld Magazine
  • About the Magazine
  • Articles
  • Media Corner
  • Privacy Policy
  • Cookie Policy

Cancerworld is funded by SPCC Sharing Progress in Cancer Care | Via Vincenzo Vela 6, 6500 Bellinzona - Switzerland | info@spcc.net

Archivio Cancerworld

Input your search keywords and press Enter.