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ROME -- The beta-blocker nebivolol (Bystolic) reduced early measures of cardiotoxicity from anthracycline chemotherapy for breast cancer, a small trial showed.
The drug "did not influence the conventional echocardiographic variables that assess the ventricular systolic and diastolic function, but prevented the change of tissue Doppler and speckle tracking imaging parameters, that indicate subclinical cardiotoxicity," , of Romania's University of Medicine and Pharmacy "Victor Babes" Timisoara, reported here at the European Society of Cardiology meeting.
For the trial, 60 women with previously-untreated, HER2-negative breast cancer and a left ventricular ejection fraction of greater than 50% were randomized to open-label nebivolol at 5 mg once daily for the duration of doxorubicin (Adriamycin, Rubex)-based chemotherapy or no nebivolol.
Echocardiography with tissue Doppler and speckle-tracking imaging within 24 hours after the last chemotherapy cycle showed no difference between groups on left ventricular ejection fraction, volume, or diameter parameters.
The nebivolol group did, though, show statistically significantly better results on:
- Isovolumic relaxation time
- Mitral annular plane systolic excursion by M-mode
- Radial and longitudinal strain
- Left ventricular filling (lateral and septal E')
- Left ventricular diastolic pressures (E/E' ratio)
The researchers noted the small study sample and short follow-up period as limitations. "Larger studies with a longer follow-up period are needed to confirm these preliminary results," Tomescu concluded.
A few prior small studies have tested beta-blockers or ACE inhibitors for anthracycline recipients, noted , of the University of Gothenburg, Sweden, who moderated a press conference where the results were presented.
"This was another attempt but underpowered, open [label], and just tells that much more needs to be done," he told ڴŮ. "But, of course, the topic is important."
The results with nebivolol weren't sufficient, though, for Swedberg to suggest this is the drug to test in a large randomized trial.
Cardio-Onco is an emerging subspecialty and at this meeting the ESC released a outlining screening and management issues around cardiotoxicity in cancer treatment.
Disclosures
Tomescu disclosed no relevant relationships with industry.
Primary Source
European Society of Cardiology
Tomescu MC, et al "Protective effect of nebivolol on anthracyclineinduced cardiotoxicity, assessed by tissue Doppler velocities and by speckle tracking echocardiography" ESC 2016; Abstract 2102.