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A Simple Bioassay for the Evaluation of Vascular Endothelial Growth Factors
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A Simple Bioassay for the Evaluation of Vascular Endothelial Growth Factors

Published on: March 15, 2016

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Congestive heart failure with vascular endothelial growth factor receptor tyrosine kinase inhibitors

Pooja Ghatalia1, Charity J Morgan2, Youjin Je3

  • 1Department of Internal Medicine, University of Alabama at Birmingham (UAB), Birmingham, AL, USA.

Critical Reviews in Oncology/Hematology
|January 12, 2015
PubMed

Insights

Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) significantly increase the risk of congestive heart failure (CHF). This meta-analysis found VEGFR TKIs nearly tripled the risk of all-grade CHF compared to no TKI treatment.

Area of Science:

  • Oncology
  • Cardiology
  • Pharmacology

Background:

  • Vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) are utilized in cancer therapy.
  • VEGFR TKIs target signaling pathways crucial for angiogenesis and tumor growth.
  • Potential cardiovascular toxicities, including congestive heart failure (CHF), are associated with VEGFR TKI use.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis.
  • To determine the relative risk (RR) of congestive heart failure (CHF) in patients treated with FDA-approved multi-targeted VEGFR tyrosine kinase inhibitors (TKIs).
  • To compare the risk of CHF between VEGFR TKI treatment arms and non-TKI control arms.

Main Methods:

  • Systematic review and meta-analysis of randomized controlled trials.
  • Inclusion criteria: Randomized trials comparing FDA-approved VEGFR TKIs with control groups.
  • Statistical analysis: Calculation of relative risk (RR) and 95% confidence intervals (CI) for CHF incidence.

Main Results:

  • A total of 10,647 patients from 16 phase III and 5 phase II trials were included.
  • The relative risk (RR) of all-grade congestive heart failure (CHF) was 2.69 (95% CI: 1.86 to 3.87; p<0.001) for VEGFR TKI users versus non-users.
  • The RR for high-grade CHF was 1.65 (95% CI: 0.73 to 3.70; p=0.227), indicating a non-significant increase.

Conclusions:

  • Multi-targeted VEGFR TKIs are associated with a significantly increased risk of all-grade congestive heart failure (CHF).
  • The risk of high-grade CHF did not reach statistical significance in this meta-analysis.
  • Both specific (axitinib) and non-specific (sunitinib, sorafenib, vandetanib, pazopanib) VEGFR TKIs demonstrated similar CHF risk profiles.
Keywords:
ApprovedCongestive heart failureMeta-analysisTyrosine kinase inhibitorsVascular endothelial growth factor receptor

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