ACE Inhibitors and Beta Blockers in treating Cardiotoxicity caused by Trastuzumab

Recent advancements in cancer therapies have helped many patients with breast cancer to achieve better outcomes and longer survival. However, this progress causes the Cardiotoxicity, associated with anticancer therapies, which ranges from subclinical abnormalities to irreversible life-threatening complications, such as cardiomyopathy or congestive heart failure.

Chemotherapeutics drugs or other medications you may be taking to control your disease may cause the cardiotoxicity where heart may not be able to pump blood throughout body by the damaged heart muscles.

One such treatment is by using the Trastuzumab which is a monoclonal antibody used in the treatment of HER2-receptor positive metastatic breast cancer. Which can be used alone or in combination with other chemotherapeutic agents. In addition, it has been indicated that Herceptin can impair the regenerative capacities of human resident cardiac stem cells. Statistical study has been proved that One in four women treated with trastuzumab develops potentially dangerous cardiac problems.

It has been recommended that patients receiving adjuvant treatment with trastuzumab should have adequate cardiac monitoring, using transthoracic ECHO or radionuclide ventriculography multiple-gated acquisition (MUGA) scans at baseline, and then at 3, 6, and 9 months after starting this treatment.

Dr. Maya Guglin and his colleagues conducted multicenter clinical trial and showed that ACE inhibitor or a beta-blocker would prevent decreased LVEF that is Cardiotoxicity.

ACE Inhibitors such as Lisinopril helps the blood vessels to enlarge or dilate, and as a result blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart by inhibiting the activity of the Angiotensin converting enzyme (ACE) which leads to the production of Angiotensin II which is potent chemical produced by the body that primarily circulates in the blood. It causes the muscles surrounding blood vessels to contract, thereby narrowing the blood vessels which finally leads to the cause of Cardiotoxicity.

Beta blockers such as Carvedilol serves by blocking the effect of hormone adrenaline also known as Epinephrine. Medications that reduces the blood pressure by helping to open the blood vessels. Which helps in reducing the blood pressure.