A study from Argentina has assessed the effectiveness of sacubitril-valsartan in patients with cancer therapy-related cardiac dysfunction (CTRCD) treated in cardio-oncology units (DOI: 10.1186/s40959-020-00078-4). The study was carried out in 635 breast cancer patients. Some 51 patients developed CTRCD, and of these, 28 were available for analysis. Most of the patients were women and treated with doxorubicin/cyclophosphamide or trastuzumab/pertuzumab.
The patients who developed cardiotoxicity were treated with beta blockers (carvedilol), angiotensin-converting enzyme inhibitors (enalapril) or angiotensin receptor blockers (valsartan), aldosterone antagonists (eplerenone), digitalis and diuretics (furosemide), as needed. When patients remained symptomatic and met the PARADIGM-HF inclusion criteria, sacubitril/valsartan was started instead of enalapril or valsartan.
Results showed that sacubitril/valsartan therapy produced an improvement in ventricular remodelling, diastolic dysfunction, and on symptoms, reflected in the New York Heart Association class and the six-minute walk test.
The authors conclude that sacubitril/valsartan is a valid option in the treatment of CTRCD patients, but a multi-centre study with a larger number of patients would be needed to reach more definitive conclusions.