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Abstract Details
Cardiovascular Toxicities Associated with Tyrosine Kinase Inhibitors
Curr Cardiol Rep. 2023 Apr;25(4):269-280. doi: 10.1007/s11886-023-01845-2.Epub 2023 Feb 16.
1Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA.
2Division of Cardiology, Department of Internal Medicine, Yale Bridgeport Hospital, Bridgeport, CT, USA.
3Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA.
4Division of Cardiology, Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
5Division of Hematology and Oncology, Department of Medicine, Medical College of Georgia at Augusta University, Augusta, GA, USA.
6Cardio-Oncology Program, Georgia Cancer Center, Medical College of Georgia, Augusta University, 1410 Laney Walker Blvd, CN 5313, Augusta, GA, 30912, USA.
7Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA.
8Vascular Biology Center, Medical College of Georgia, Augusta University, Augusta, GA, USA.
9Department of Vascular Surgery, Cardiovascular Research Institute, Stanford University, Palo Alto, CA, USA.
10Cardio-Oncology Program, Division of Cardiology, The Ohio State University Medical Center, Columbus, OH, USA. aguha@augusta.edu.
11Cardio-Oncology Program, Georgia Cancer Center, Medical College of Georgia, Augusta University, 1410 Laney Walker Blvd, CN 5313, Augusta, GA, 30912, USA. aguha@augusta.edu.
12Division of Cardiology, Department of Medicine, Medical College of Georgia, Augusta University, Augusta, GA, USA. aguha@augusta.edu.
Abstract
Purpose of review: To provide a detailed overview of cardiovascular adverse events associated with the use of tyrosine kinase inhibitors across different tumor types.
Recent findings: Despite an undeniable survival advantage of tyrosine kinase inhibitors (TKIs) in patients with hematologic or solid malignancies, the accompanying off-target cardiovascular adverse events can be life-threatening. In patients with B cell malignancies, the use of Bruton tyrosine kinase inhibitors has been associated with atrial and ventricular arrhythmias, as well as hypertension. Cardiovascular toxic profiles are heterogeneous among the several approved breakpoint cluster region (BCR)-ABL TKIS. Notably, imatinib might be cardioprotective. Vascular endothelial growth factor TKIs, constituting the central axis in the treatment of several solid tumors, including renal cell carcinoma and hepatocellular carcinoma, have strongly been associated with hypertension and arterial ischemic events. Epidermal growth factor TKIs as therapy for advanced non-small cell lung cancer (NSCLC) have been reported to be infrequently associated with heart failure and QT prolongation. While tyrosine kinase inhibitors have been demonstrated to increase overall survival across different types of cancers, special consideration should be given to cardiovascular toxicities. High-risk patients can be identified by undergoing a comprehensive workup at baseline.