VEGF pathway inhibition by anticancer agent sunitinib and susceptibility to atherosclerosis plaque disruption.
Patients treated with anti-VEGF agents are at increased risk for arterial thrombo-embolic events (ATEs). However, the pathophysiology of such acute vascular complications remains unclear. We report on a case of bowel infarction in a renal cancer patient treated with the anti-VEGF agent sunitinib. An abdominal CT-scan evidenced the rupture of an atherosclerotic plaque located at the emergence of the superior mesenteric artery. In view of this report, we suggest that evaluation of the risk of ATE in patients receiving anti-VEGF agents should include not only age and past history of ATE as suggested by previous studies, but also assessment of atherosclerotic lesions on CT-scan.
Ropert
Stanislas
S
Centre for Research on Angiogenesis Inhibitors (CERIA), Department of Medical Oncology, AP-HP, Cochin Teaching Hospital, Université Paris Descartes, 27, rue du faubourg saint Jacques, F75014, Paris, France.
Vignaux
Olivier
O
Mir
Olivier
O
Goldwasser
François
F
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects* / Q000494:pharmacology; D006801:Humans; D007211:Indoles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D007238:Infarction / Q000209:etiology; D007422:Intestines / Q000098:blood supply; D008297:Male; D058226:Plaque, Atherosclerotic / Q000473:pathology*; D011758:Pyrroles / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use; D012307:Risk Factors; D000077210:Sunitinib; D013923:Thromboembolism / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
D020533:Angiogenesis Inhibitors; D000970:Antineoplastic Agents; D007211:Indoles; D011758:Pyrroles; D042461:Vascular Endothelial Growth Factor A; D000077210:Sunitinib