Role of Enalapril and Carvedilol in Non Metastatic Breast Cancer patients Receiving Anthracycline Containing Chemotherapy

Abstract

A dvances in breast cancer treatment have improved disease-free survival and overall survival in women with early-stage breast cancer. However, these improvements may be attenuated by the adverse cardiovascular effects associated with breast cancer adjuvant therapy (Yu and Jones, 2016). Current strategies have focused on screening and prevention of cardiomyopathy and include treatment modification based on patient specific risk profiles, intensive monitoring for early detection of cardiovascular injury using imaging and circulating biomarkers, and pharmacologic intervention with cardioprotective medications (e.g. beta-blockers or ACE-inhibitors) (Plana et al, 2014) . This trial was a prevention, phase III, randomized, controlled trial, aimed to assess efficacy and safety of cardioprotective effect of Enalapril and Carvedilol with different anthracycline containing regimens +/- Trastuzumab as measured by the change from baseline in global LVEF by echocardiogrphy and cardiac magnetic resonance imaging as primary end point. Secondary end point was subgroup analysis according to the incidence of an absolute decrease in LVEF ≥10%, heart failure, or significant LVSD (defined by an LVEF<45%) or deterioration in LV diastolic function. Breast cancer patients in this study were randomly assigned in a 1:1 ratio to receive (the intervention group) or not to receive (the control group) enalapril and carvedilol. All patients were evaluated by history taking including history of cardiac diseases and full clinical examination.