Lewinter C, Nielsen TH, Edfors LR, et al. - In patients with breast cancer, both beta-blockers (BBs) and angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blocker (ARB) therapies were found to be associated with the preservation of left ventricular ejection fraction (LVEF) during trastuzumab and anthracycline-containing regimens vs placebo, indicating both to be beneficial.

• In this meta-analysis, randomized controlled trials (RCTs) of breast cancer patients that have assessed the impacts of BBs, ARBs, and ACEI on trastuzumab- and anthracycline-associated cardiotoxicity, were analyzed.

• A total of nine RCTs (n = 1,362; all patients were women) from PubMed, Embase, and CENTRAL were included in the analysis.

• According to findings, LVEF reduction during trastuzumab and anthracycline treatments was attenuated by BBs and ACEI/ARBs [mean difference (MD): 2.4; 95% confidence interval (CI): 0.3–4.2 and MD: 1.5; 95% CI: –0.6 to 3.7].

• Relative to placebo, a significantly higher LVEF was seen in patients assigned to BB or ACEI/ARB on trastuzumab (MD: 2.3; 95% CI: 0.0–4.6) but not on anthracyclines (MD: 1.9; 95% CI: –0.5 to 4.2).