Cardiovascular Toxicities Associated with Tyrosine Kinase Inhibitors.
Nicolas SayeghJuliet YirerongNeeraj AgarwalDaniel AddisonMichael FradleyJorge CortesNeal L WeintraubNazish SayedGirindra RavalAvirup GuhaPublished in: Current cardiology reports (2023)
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.
Keyphrases
- chronic myeloid leukemia
- advanced non small cell lung cancer
- growth factor
- heart failure
- vascular endothelial growth factor
- blood pressure
- renal cell carcinoma
- end stage renal disease
- epidermal growth factor receptor
- small cell lung cancer
- tyrosine kinase
- newly diagnosed
- left ventricular
- chronic kidney disease
- atrial fibrillation
- acute lymphoblastic leukemia
- peritoneal dialysis
- prognostic factors
- free survival
- ischemia reperfusion injury
- congenital heart disease
- left atrial
- cerebral ischemia
- wound healing