QT interval prolongation among patients treated with angiogenesis inhibitors.
Among toxicities associated with molecular targeted agents (MTA), cardiovascular toxicities remain largely unknown or underestimated. Their frequency is variable and dependent on the compound. A high incidence of hypertension, symptomatic or asymptomatic left ventricular systolic dysfunction, acute coronary syndrome, arterial and venous thrombosis has been observed in patients receiving MTA. One of the most threatening complications of angiogenic inhibitors (AI) could be QT prolongation with the risk of torsade de pointes (TdP) and sudden death. QT prolongation and torsade de pointes accounted for 29% of cardiac and non-cardiac post-marketing withdrawals. The assessment of the effects of drugs on cardiac repolarization is the subject of recent guidelines and recommendations. Regulatory agencies now require practically every new pharmaceutical compound to undergo a thorough investigation of its propensity to modify cardiac repolarization. To reduce the incidence of QT prolongation and torsade de pointes in patients receiving AI, cancer patients should be closely monitored while receiving AI.
Cardiology Department, Saint-Antoine University and Medical School, Paris Cedex 12, France.
Stephane
S
Ederhy
Ariel
A
Cohen
Ghislaine
G
Dufaitre
Hassan
H
Izzedine
Christophe
C
Massard
Catherine
C
Meuleman
Benjamin
B
Besse
Emmanuelle
E
Berthelot
Franck
F
Boccara
Jean-Charles
JC
Soria
D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced / Q000628:therapy; D004353:Drug Evaluation, Preclinical; D004554:Electric Countershock; D004562:Electrocardiography / Q000187:drug effects*; D006321:Heart / Q000187:drug effects* / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000628:therapy; D008274:Magnesium / Q000627:therapeutic use; D047428:Protein Kinase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D020246:Venous Thrombosis / Q000139:chemically induced / Q000188:drug therapy; D018754:Ventricular Dysfunction / Q000139:chemically induced / Q000628:therapy; D028761:Withholding Treatment
D020533:Angiogenesis Inhibitors; D047428:Protein Kinase Inhibitors; D008274:Magnesium