An ACE inhibitor or beta-blocker can significantly reduce cardiotoxicity in women with HER2-positive breast cancer being treated with doxyrubicin and trastuzumab (Herceptin).

The findings, presented at the American College of Cardiology’s 67th Annual Scientific Session in Orlando, showed lower cardiac event rates with ACE inhibitors (37%) and beta-blockers (31%) compared to placebo (47%).

However the multicentre study of 468 patients found the cardiovascular agents did not help preserve ejection fraction in patients receiving trastuzumab alone.

The findings provide some guidance in the context of considerable concern about the raised cardiovascular risk in women with breast cancer.

Cardiologist Dr Maya Guglin, from the University of Kentucky’s Gill Heart and Vascular Institute, told the conference that adding either an ACE inhibitor or a beta-blocker to the treatment regimen could significantly offset the chance of heart problems.

“This data is the crucial first step towards establishing a new standard of care to reduce the risk of cardiotoxicity for patients undergoing treatment for HER2-positive breast cancer,” she said.

“Herceptin is arguably the most effective treatment for HER2-positive breast cancer. These patients are already anxious about their future. We don’t want to avoid this exceptionally effective treatment just because it might cause damage to the heart.”

Oncologist Dr Mark Evers, director of the University of Kentucky’s Markey Cancer Center, said huge strides had been made in treating cancers over the past few decades.

“But it’s important to also think about the patient’s future and to help them maintain the best possible quality of life. This study provides valuable information for oncologists who are treating patients with HER2-positive breast cancer, and may help shape the new standard of treatment for this cancer in years to come.”