SGLT2 inhibitors are not going to prove a threat to bisantrene for a number of reason beyond that they haven't even been shown to work as an anticancer agent in animal models. The major one is the anticancer activity needs to be as broadly active as doxorubicin and not targeted to a tiny fraction of all cancers like SGLT2.
The second is nobody is going to pay for the trials to prove out SGLT2 inhibitors in the clinic as there is no way to protect against generic competition.
The third is oncologists are so reluctant to change anything to do with chemotherapy that the first drug to capture the anticancer cardioprotective market will be impossible to displace. This is the reason we can't sell bisantrene as a better and safer alternative to doxorubicin even though it is clinically proven to provide longer life expectancy than doxorubicin in breast cancer patients with far fewer side effects. This is sad, but the reality of chemotherapy today.
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