Breast cancer survivors whose treatment-related heart problems have recovered may not need to remain on heart medication for life, a UK trial suggests.
The HER-SAFE study found that 98 per cent of women who stopped their treatment showed no deterioration in heart function after 12 months. One participant developed a moderate, symptom-free decline detected on an MRI scan, but there were no cardiovascular deaths, heart-failure hospital admissions or symptomatic cardiac events. ([imedsource.org](https://www.imedsource.org/journal/safety_of_withdrawal_of_pharmacological_treatment_after_recovery_from_her2_therapyrelated_cardiac_dysfunction_the_hersafe_trial))
The trial, led by Professor Charlotte Manisty of University College London and Barts Heart Centre, involved 90 women whose heart function had been affected by anti-HER2 breast cancer treatment but had subsequently recovered.
Participants were randomly assigned either to withdraw from heart-failure therapy or to continue taking it. The medicines were mainly renin-angiotensin system inhibitors, used by 98 per cent of the women, and beta-blockers, taken by 88 per cent. ([imedsource.org](https://www.imedsource.org/journal/safety_of_withdrawal_of_pharmacological_treatment_after_recovery_from_her2_therapyrelated_cardiac_dysfunction_the_hersafe_trial))
Patients who stopped the drugs were closely monitored with heart scans, blood tests and assessments of their quality of life. The researchers reported that left ventricular ejection fraction – a measure of the heart’s pumping ability – remained stable in both groups after a year.
Heart medication withdrawal offers hope to breast cancer survivors
Professor Manisty said modern breast cancer treatment had brought major advances, but damage caused to the heart could leave patients and doctors uncertain about how long protective medication should continue.
The study provides early evidence that treatment can be withdrawn safely in carefully selected survivors whose heart function has recovered, provided they remain under close medical supervision, the researchers said.
Dr Sonya Babu-Narayan of the British Heart Foundation described the results as “hugely encouraging” for thousands of survivors whose heart health has been affected by cancer treatment. She stressed that more research and longer follow-up would be needed.
The women in the trial are due to be followed for five years. The findings apply to survivors with recovered heart dysfunction after anti-HER2 therapy and do not mean patients should stop their medication without advice from their medical team. ([imedsource.org](https://www.imedsource.org/journal/safety_of_withdrawal_of_pharmacological_treatment_after_recovery_from_her2_therapyrelated_cardiac_dysfunction_the_hersafe_trial))
