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Tyrosine Kinase Inhibitors and Vascular Toxicity: Impetus for a Classification System?
1Division of Cardiovascular Diseases, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. herrmann.joerg@mayo.edu.
Abstract:
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.
Insights
Molecularly targeted cancer therapies, like tyrosine kinase inhibitors, can cause cardiac and vascular toxicity. Understanding these side effects is crucial for improving patient care and cancer treatment outcomes.
Area of Science:
- Oncology
- Cardiovascular Medicine
- Pharmacology
Background:
- Molecularly targeted therapies, particularly tyrosine kinase inhibitors (TKIs), have transformed cancer treatment, leading to reduced mortality.
- Despite their efficacy, TKIs are associated with significant cardiovascular and vascular toxicities.
- These toxicities can be on-target effects or unanticipated events, necessitating a deeper understanding.
Purpose of the Study:
- To review the vascular side effects of currently used tyrosine kinase inhibitors in cancer therapy.
- To explore the mechanistic insights into TKI-induced vascular disease.
- To discuss the clinical implications of these cardiovascular toxic effects.
Main Methods:
- Literature review of tyrosine kinase inhibitors in clinical use.
- Analysis of reported vascular and cardiac side effects.
- Categorization of toxicities into type I (permanent) and type II (transient) where applicable.
Main Results:
- TKIs exhibit a range of vascular toxicities, including effects on blood vessels and the heart.
- VEGF receptor inhibitors commonly cause on-target vascular effects.
- Other TKIs, such as BCR-Abl inhibitors, can lead to unanticipated vascular events.
Conclusions:
- A comprehensive understanding of TKI-associated vascular toxicity is essential for clinical management.
- Distinguishing between permanent and transient toxicities may aid in patient care strategies.
- Further research into mechanisms can optimize the use of TKIs in cancer therapy.
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