Heart failure (HF) patients have a significantly higher risk of new-onset cancer and cancer-associated mortality, compared to subjects free of HF. While both the prevention and treatment of new-onset HF in patients with cancer have been investigated extensively, less is known about the prevention and treatment of new-onset cancer in patients with HF, and whether and how guideline-directed medical therapy (GDMT) for HF should be modified when cancer is diagnosed in HF patients. The purpose of this review is to elaborate and discuss the effects of pillar HF pharmacotherapies, as well as digoxin and diuretics on cancer, and to identify areas for further research and novel therapeutic strategies. To this end, in this review, (i) proposed effects and mechanisms of action of guideline-directed HF drugs on cancer derived from pre-clinical data will be described, (ii) the evidence from both observational studies and randomized controlled trials on the effects of guideline-directed medical therapy on cancer incidence and cancer-related outcomes, as synthetized by meta-analyses will be reviewed, and (iii) considerations for future pre-clinical and clinical investigations will be provided.

中文翻译：

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心力衰竭药物治疗和癌症：途径和临床前/临床证据

与无心力衰竭的受试者相比，心力衰竭（HF）患者新发癌症和癌症相关死亡率的风险显着更高。虽然癌症患者新发癌症的预防和治疗已得到广泛研究，但对于心力衰竭患者新发癌症的预防和治疗，以及是否以及如何进行指南指导的药物治疗 (GDMT) 知之甚少。当心力衰竭患者诊断出癌症时，应修改心力衰竭的治疗方案。本综述的目的是阐述和讨论支柱性心力衰竭药物疗法以及地高辛和利尿剂对癌症的作用，并确定进一步研究的领域和新的治疗策略。为此，在本次综述中，（i）将描述根据临床前数据得出的指南指导的心力衰竭药物对癌症的拟议作用和作用机制，（ii）来自观察性研究和随机对照试验的证据将审查通过荟萃分析综合的指南指导的药物治疗对癌症发病率和癌症相关结果的影响，并且（iii）将提供对未来临床前和临床研究的考虑。