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Updated: Jun 21, 2026
Chemotherapy-induced Vascular Toxicity - Real-time In vivo Imaging of Vessel Impairment
Published on: January 7, 2015
Cardiovascular and renal toxicity during angiogenesis inhibition: clinical and mechanistic aspects
Mariëtte Hw Kappers1, Joep H M van Esch, Stefan Sleijfer
1Division of Pharmacology, Vascular and Metabolic Diseases, Department of Internal Medicine, Erasmus MC, Rotterdam, The Netherlands.
Abstract:
Inhibition of angiogenesis with humanized monoclonal antibodies to vascular endothelial growth factor (VEGF) or with tyrosine kinase inhibitors targeting VEGF receptors has become an established treatment for various tumor types. Contrary to expectations, angiogenesis inhibition by blocking VEGF-mediated signaling is associated with serious side effects including hypertension and renal and cardiac toxicity in a substantial proportion of patients. Fortunately, most of these side effects as discussed in this paper seem to be manageable, but likely become more problematic when survival increases. Although several hypotheses regarding the etiology of angiogenesis inhibition-related cardiovascular and renal side effects have been postulated, many of the underlying pathophysiological mechanisms remain to be elucidated. This may lead to the development of more specific angiogenesis inhibitors, better management of their side effects and may potentially provide new insights into the pathogenesis of cardiovascular disease in general.
Insights
Blocking vascular endothelial growth factor (VEGF) in cancer treatment causes side effects like hypertension and organ toxicity. Understanding these mechanisms is key to improving patient outcomes and developing safer therapies.
Area of Science:
- Oncology
- Cardiovascular Research
- Nephrology
Background:
- Anti-angiogenesis therapies targeting vascular endothelial growth factor (VEGF) are standard cancer treatments.
- These therapies, including monoclonal antibodies and tyrosine kinase inhibitors, block VEGF-mediated signaling.
- Unexpectedly, these treatments are linked to significant cardiovascular and renal toxicities.
Purpose of the Study:
- To review the side effects associated with anti-angiogenesis therapies.
- To explore potential mechanisms behind cardiovascular and renal toxicities.
- To discuss strategies for managing these adverse events.
Main Methods:
- Literature review of studies on anti-angiogenesis therapy side effects.
- Analysis of postulated hypotheses for the etiology of cardiovascular and renal toxicity.
- Discussion of clinical implications and future research directions.
Main Results:
- Hypertension, renal toxicity, and cardiac toxicity are common side effects.
- While often manageable, these toxicities may worsen with increased patient survival.
- The precise pathophysiological mechanisms underlying these side effects require further elucidation.
Conclusions:
- Further research into the mechanisms of VEGF-targeted therapy side effects is crucial.
- Improved understanding can lead to more specific inhibitors and better side effect management.
- Insights may also advance general cardiovascular disease pathogenesis understanding.
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