The Role of Metoprolol and Enalapril in the Prevention of Doxorubicin-induced Cardiotoxicity in Lymphoma Patients

Anticancer Res. 2019 Oct;39(10):5703-5707. doi: 10.21873/anticanres.13769.

Abstract

Background/aim: Anthracyclines, such as doxorubicin, though widely used in anticancer therapy, they are associated with cardiotoxic side-effects. The aim of this trial was to investigate long-term follow-up cardiotoxicity findings in patients treated with doxorubicin and concomitant metoprolol or enalapril 10 years earlier.

Patients and methods: Overall, 147 patients were randomized into the treatment arms. A total of 125 patients treated with doxorubicin without evidence of heart disease at the start of chemotherapy were analyzed. They were followed-up for up to 10 years after treatment start.

Results and conclusion: A total of 47 patients completed the follow-up and 21 patients died, none due to cardiotoxicity events. Clinical signs of heart failure were not seen in any patients and no statistically significant differences between baseline and 10-year findings were seen for echocardiographic variables. No evidence of long-term cardiotoxicity was seen and nor metoprolol or enalapril offered an additional benefit.

Keywords: Doxorubicin; cardiotoxicity; lymphoma.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Anthracyclines / therapeutic use
  • Antibiotics, Antineoplastic / adverse effects*
  • Antibiotics, Antineoplastic / therapeutic use
  • Cardiotoxicity / etiology
  • Cardiotoxicity / prevention & control*
  • Doxorubicin / adverse effects*
  • Doxorubicin / therapeutic use
  • Echocardiography / methods
  • Enalapril / therapeutic use*
  • Female
  • Heart Failure / chemically induced
  • Heart Failure / drug therapy
  • Humans
  • Lymphoma / drug therapy*
  • Male
  • Metoprolol / therapeutic use*
  • Prospective Studies

Substances

  • Anthracyclines
  • Antibiotics, Antineoplastic
  • Enalapril
  • Doxorubicin
  • Metoprolol