title: Sorafenib-associated multivessel coronary artery vasospasm.
abstract: Cardiotoxicity associated with cancer treatment is an important field of interest especially as the new class of VEGF signaling pathway inhibitors (VSP) continues to grow. Small molecule tyrosine kinase inhibitors such as sorafenib, sunitinib, and pazopanib inhibit the downstream pathways of all three of the vascular endothelial growth factor receptors (VEGFR 1, 2, and 3). Other targets of these agents include kinases involved in vascular and myocardial homoeostasis. These agents are all known to frequently cause hypertension, their most common side-effect. Myocardial ischemia has also been reported, but the frequency and etiology of VSP-related ischemia is poorly characterized. This manuscript describes the first reported case of sorafenib-associated multivessel coronary vasospasm in a 57-year-old patient with hepatocellular carcinoma. He underwent sorafenib treatment, a tyrosinase inhibitor, 400 mg twice a day. The vasospasm was reversible under nitroglycerin. Possible mechanisms are also discussed.
authors.affiliation: Division of Cardiology, Memorial Sloan-Kettering Cancer Center, New York, USA.
authors.forename: T
authors.initials: T
authors.lastname: Naib
authors.forename: R M
authors.initials: RM
authors.lastname: Steingart
authors.forename: C L
authors.initials: CL
authors.lastname: Chen
mesh_terms: D000970:Antineoplastic Agents / Q000009:adverse effects; D001557:Benzenesulfonates / Q000009:adverse effects*; D003329:Coronary Vasospasm / Q000139:chemically induced* / Q000175:diagnosis* / Q000517:prevention & control; D004562:Electrocardiography / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000031:analogs & derivatives; D010671:Phenylurea Compounds; D011725:Pyridines / Q000009:adverse effects*; D000077157:Sorafenib
chemical_list: D000970:Antineoplastic Agents; D001557:Benzenesulfonates; D010671:Phenylurea Compounds; D011725:Pyridines; D009536:Niacinamide; D000077157:Sorafenib