Pharmacological cardioprotective strategy for non-metastatic patients affected by breast cancer receiving an anthracycline-based chemotherapy: Final results of the phase 3 SAFE trial

The optimal approach to prevent myocardial dysfunction when giving anthracycline chemotherapy remains a challenge. The SAFE trial is a phase 3 double-blind placebo-controlled study. It looked at giving bisoprolol (a beta blocker), ramipril (ACE inhibitor), or the combination vs placebo for one year from the start of chemotherapy. It looked at cancer therapy-related LVEF decline and heart remodeling. Use of the agents was well tolerated and at the 24-month assessment appeared to be protective of cardiac function.