Evidence map›Paper›PMID 31171092›Full record

Trial reportJournal of the American College of Cardiology2019

Randomized Trial of Lisinopril Versus Carvedilol to Prevent Trastuzumab Cardiotoxicity in Patients With Breast Cancer.

Maya Guglin, Jeffrey Krischer, Roy Tamura, Angelina Fink, Lauren Bello-Matricaria, Worta McCaskill-Stevens, Pamela N Munster

2 registry-linked trialsOpen access · greenAbstract readComparative StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 170 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
170citing papers in PubMed, 11 pooled it
27.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01009918 phase2completednot on this map

Phase II Placebo-controlled Trial of Lisinopril and Coreg CR® to Reduce Cardiotoxicity in Patients With Breast Cancer Receiving (Neo)Adjuvant Chemotherapy With Trastuzumab (Herceptin®)

TypeinterventionalSponsorUniversity of South FloridaRan2010 to 2018Enrolled468ConditionsBreast Cancer, Cardiac ToxicityArmsCoreg CR®, lisinopril, placebo
NCT06304896 phase1unknown statusnot on this mapstarted 2024, after this paper: background citation

Colchicine Versus Beta-blockers, Angiotensin-converting Enzyme Inhibitors, and Statins for Prevention of Chemotherapy-Induced Cardiomyopathy

TypeinterventionalSponsorArab Contractors Medical CentreRan2024 to 2025Enrolled150ConditionsChemotherapy Induced Systolic DysfunctionArmsCarvedilol, Ramipril, Rosuvastatin, Colchicine, Placebo
3 · Its place in the literature

Who cites it

170 citing papers in PubMed, 11 syntheses or guidelines pooled it, 273 citations in OpenAlex.

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  6. Brazilian Society of Cardiology Guideline on Myocarditis - 2022.Arquivos brasileiros de cardiologia · 2022
    Guideline
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  15. Article
  16. Risk-guided cardioprotection in cardio-oncology.Nature cardiovascular research · 2026
    Review
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  18. Recent updates and perspectives in "Onco-hypertension".Hypertension research : official journal of the Japanese Society of Hypertension · 2026
    Review
  19. Article
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110 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 1 country.

Maya GuglinUniversity of Kentucky, Gill Heart & Vascular Institute, Lexington, Kentucky. Electronic address: maya.guglin@uky.edu.
Jeffrey KrischerUniversity of South Florida, Health Informatics Institute, Tampa, Florida.
Roy TamuraUniversity of South Florida, Health Informatics Institute, Tampa, Florida.
Angelina FinkH. Lee Moffitt Cancer Center & Research Institute, Tampa, Florida.
Lauren Bello-MatricariaUniversity of South Florida, Health Informatics Institute, Tampa, Florida.
Worta McCaskill-StevensNational Cancer Institute, Community Oncology and Prevention Trials Research Group, Rockville, Maryland.
Pamela N MunsterUniversity of California San Francisco, San Francisco, California.
University of South Florida · USMoffitt Cancer Center · USNational Cancer Institute · USUniversity of California, San Francisco · USUniversity of Kentucky · US

Funding

SunCoast CCOP Research Base at the University of South FloridaU10CA081920 · NCI · UNIVERSITY OF SOUTH FLORIDA · PI KRISCHER, JEFFREY P · 2000 to 2015
$16.9M
NCI NIH HHS U10 CA081920
6 · The paper itself

Abstract

backgroundTrastuzumab is highly effective for human epidermal growth factor receptor type 2 (HER2)-positive breast cancer but is associated with a decline in left ventricular ejection fraction.

objectivesThe purpose of this study was to determine whether angiotensin-converting enzyme inhibitors or beta-blockers reduce the rate of trastuzumab-induced cardiotoxicity (left ventricular ejection fraction decrease >10%, or >5% if below 50%) and limit treatment interruptions.

methodsIn this double-blind, multicenter, placebo-controlled trial, cardiotoxicity and treatment interruptions in patients with HER2-positive breast cancer treated with trastuzumab for 12 months were evaluated over a 2-year period. Patients were stratified by anthracycline use and then randomized to receive lisinopril, carvedilol, or placebo.

resultsThe study included 468 women, age 51 ± 10.7 years. For the entire cohort, cardiotoxicity was comparable in the 3 arms and occurred in 32% of patients on placebo, 29% on carvedilol, and 30% on lisinopril. For patients receiving anthracyclines, the event rates were higher in the placebo group (47%) than in the lisinopril (37%) and the carvedilol (31%) groups. Cardiotoxicity-free survival was longer on both carvedilol (hazard ratio: 0.49; 95% confidence interval: 0.27 to 0.89; p = 0.009) and lisinopril (hazard ratio: 0.53; 95% confidence interval: 0.30 to 0.94; p = 0.015) than on placebo. In the whole cohort, as well as in the anthracycline arm, patients on active therapy with either angiotensin-converting enzyme inhibitor or beta-blockers experienced fewer interruptions in trastuzumab than those on placebo.

conclusionsIn patients with HER2-positive breast cancer treated with trastuzumab, both lisinopril and carvedilol prevented cardiotoxicity in patients receiving anthracyclines. For such patients, lisinopril or carvedilol should be considered to minimize interruptions of trastuzumab. (Lisinopril or Coreg CR in Reducing Side Effects in Women With Breast Cancer Receiving Trastuzumab; NCT01009918).

Indexed as

AdultAgedAntineoplastic AgentsBreast NeoplasmsCardiotonic AgentsCarvedilolFemaleHeartHumansLisinoprilMiddle AgedStroke VolumeTrastuzumabAntineoplastic AgentsCardiotonic AgentsCarvedilolLisinoprilTrastuzumabbreast cancercardiotoxicityejection fractionheart failuretrastuzumab

Identifiers

PMID31171092
PMCPMC6557296
OpenAlexW2948656647

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.