Major Adverse Cardiovascular Events in Angiogenesis Inhibitor-Based Cancer Therapy: A Systematic Review and...

Area of Science:

• Oncology
• Cardiology
• Pharmacology

Background:

• Angiogenesis inhibitors (AIs) are vital in cancer therapy by suppressing tumor vasculature.
• AIs are linked to significant cardiovascular toxicities, including hypertension, thrombosis, and heart failure.
• These risks may escalate when AIs are combined with chemotherapy or immunotherapy.

Purpose of the Study:

• To evaluate the cardiovascular adverse events associated with angiogenesis inhibitors.
• To determine the types, incidence, and severity of cardiovascular risks linked to AIs.

Main Methods:

• A systematic review of randomized controlled trials evaluating AI therapies.
• Analysis of data from 64 studies encompassing 27,639 patients using a random-effects model.
• Primary outcomes included major adverse cardiovascular events: hypertension, thrombosis, arrhythmias, myocardial ischemia, and left ventricular dysfunction.

Main Results:

• AI treatment significantly increased hypertension (RR, 3.28), myocardial ischemia/infarction (RR, 2.09), arrhythmia (RR, 1.25), thrombotic events (RR, 1.46), and left ventricular dysfunction (RR, 2.00).
• Subgroup analyses revealed heightened risks when AIs were combined with chemotherapy or other targeted therapies.

Conclusions:

• Angiogenesis inhibitors substantially elevate cardiovascular event risk in cancer patients.
• The combination of AIs with other cancer treatments further amplifies these risks.
• Clinicians must carefully weigh AI benefits against cardiovascular risks and explore mitigation strategies.