Tyrosine Kinase Inhibitors and Vascular Toxicity: Impetus for a Classification System?
The introduction of molecularly targeted therapies with tyrosine kinase inhibitors has revolutionized cancer therapy and has contributed to a steady decline in cancer-related mortality since the late 1990s. However, not only cardiac but also vascular toxicity has been reported for these agents, some as expected on-target effects (e.g., VEGF receptor inhibitors) and others as unanticipated events (e.g., BCR-Abl inhibitors). A sound understanding of these cardiovascular toxic effects is critical to advance mechanistic insight into vascular disease and clinical care. From a conceptual standpoint, there might be value in defining type I (permanent) and type II (transient) vascular toxicity. This review will focus on the tyrosine kinase inhibitors in current clinical use and their associated vascular side effects.
Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. herrmann.joerg@mayo.edu.
Joerg
J
Herrmann
D000818:Animals; D000970:Antineoplastic Agents / Q000009:adverse effects*; D054715:Cardiotoxins / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*
D000970:Antineoplastic Agents; D054715:Cardiotoxins; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
Angina; Cancer; Cardiomyopathy; Chemotherapy; Endothelial dysfunction; Myocardial infarction; Stroke; Thrombosis; Vasospasm