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Preventing Cardiotoxicity Associated With Breast Cancer Therapy.

With Breast Cancer Therapy An angiotensin-converting enzyme (ACE) inhibitor and β-blocker prevented cardiotoxicity associated with combination chemotherapy in women with ERBB2 (formerly HER2)–positive breast cancer, reported a trial in the Journal of the American College of Cardiology. The study included 468 women receiving 12 months of trastuzumab chemotherapy. Participants were stratified by anthracycline chemotherapy use and randomized to 1 of 3 groups: placebo, lisinopril (ACE inhibitor), or carvedilol (β-blocker) treatment. Cardiotoxicity was comparable across the 3 groups for the entire study cohort. However, for women receiving combination anthracycline-trastuzumab chemotherapy, the incidence of cardiac dysfunction was lower in the lisinopril group (37%) and in the carvedilol group (31%) than in the placebo group (47%). Lisinopril and carvedilol were also associated with longer cardiotoxicity-free survival compared with placebo. All women who received lisinopril or carvedilol had fewer interruptions in their trastuzumab therapy than those who received placebo.