Management of cardiac toxicity in patients receiving vascular endothelial growth factor signaling pathway inhibitors

Richard M. Steingart, George L. Bakris, Helen X. Chen, Ming Hui Chen, Thomas Force, S. Percy Ivy, Carl V. Leier, Glenn Liu, Daniel Lenihan, Joann Lindenfeld, Michael L. Maitland, Scot C. Remick, W. H.Wilson Tang

Research output: Contribution to journalReview article

87 Scopus citations

Abstract

Background: Interfering with angiogenesis is an effective, widely used approach to cancer therapy, but antiangiogenic therapies have been associated with important systemic cardiovascular toxicities such as hypertension, left ventricular dysfunction, heart failure, and myocardial ischemia and infarction. As the use of vascular endothelial growth factor signaling pathway (VSP) inhibitors broadens to include older patients and those with existing cardiovascular disease, the adverse effects are likely to be more frequent, and cardiologists will increasingly be enlisted to help oncologists manage patients who develop adverse cardiovascular effects. Methods: The Cardiovascular Toxicities Panel of the National Cancer Institute reviewed the published literature and abstracts from major meetings, shared experience gained during clinical development of VSP inhibitors, and contributed extensive clinical experience in evaluating and treating patients with cancer with cardiovascular disease. This report was edited and approved by the National Cancer Institute Investigational Drug Steering Committee. It presents the panel's expert opinion on the current clinical use and future investigation for safer, more expansive use of these drugs. Results and Conclusions: The panel recommends that physicians (1) conduct and document a formal risk assessment for existing cardiovascular disease and potential cardiovascular complications before VSP inhibitor treatment recognizing that preexisting hypertension and cardiovascular disease are common in patients with cancer, (2) actively monitor for blood pressure elevations and cardiac toxicity with more frequent assessments during the first treatment cycle, and (3) aggressively manage blood pressure elevations and early symptoms and signs of cardiac toxicity to prevent clinically limiting complications of VSP inhibitor therapy.

Original languageEnglish
Pages (from-to)156-163
Number of pages8
JournalAmerican heart journal
Volume163
Issue number2
DOIs
StatePublished - Feb 2012
Externally publishedYes

Fingerprint Dive into the research topics of 'Management of cardiac toxicity in patients receiving vascular endothelial growth factor signaling pathway inhibitors'. Together they form a unique fingerprint.

  • Cite this

    Steingart, R. M., Bakris, G. L., Chen, H. X., Chen, M. H., Force, T., Ivy, S. P., Leier, C. V., Liu, G., Lenihan, D., Lindenfeld, J., Maitland, M. L., Remick, S. C., & Tang, W. H. W. (2012). Management of cardiac toxicity in patients receiving vascular endothelial growth factor signaling pathway inhibitors. American heart journal, 163(2), 156-163. https://doi.org/10.1016/j.ahj.2011.10.018