Cancer treatment-related cardiotoxicity: a focus on sacubitril/valsartan

Abstract

Cardiotoxicity is the most dramatic complication of cancer therapies, and it results in the cessation of potentially life-saving antitumor treatment regimens and a poor survival prognosis in a nonnegligible proportion of patients. Angiotensin converting enzyme inhibitors (ACEIs) and β-blockers are effective in the treatment of cancer therapy-related cardiac dysfunction (CTRCD), whereas their roles in the prevention of cardiotoxicity are unclear. Sacubitril/valsartan, which is an angiotensin receptor-neprilysin inhibitor, has been shown to be advantageous over ACEIs in heart failure patients with reduced ejection fraction for further the reduction of cardiovascular death or rehospitalization. However, patients with CTRCD were excluded from pivotal trials involving sacubitril/valsartan. Although several small observational studies have observed excellent performance in improving cardiac structure and function in patients with CTRCD, large-scale prospective clinical studies are required to confirm these results. In this review, we described the contemporary literature concerning the potential benefit of sacubitril/valsartan in the cardio-oncology setting.