Vascular Toxicities of Cancer Therapies: 2025 Update

Area of Science:

• Oncology
• Cardiovascular Medicine
• Pharmacology

Background:

• Cancer therapies have improved patient outcomes, but often cause adverse events.
• Vascular toxicities are a significant concern, ranging from vasoreactivity issues to atherosclerosis and thrombotic events.
• Specific cancer treatments are linked to distinct vascular complications.

Purpose of the Study:

• To comprehensively review the mechanisms of vascular complications from various cancer therapies.
• To identify key contributors to these toxicities, such as endothelial dysfunction, oxidative stress, and inflammation.
• To inform the development of optimal treatment and preventive strategies for cancer patients.

Main Methods:

• Literature review of vascular complications associated with chemotherapy, targeted therapies, immunotherapies, and radiation.
• Analysis of mechanisms including endothelial injury, oxidative stress, and inflammation.
• Categorization of toxicities by treatment type and specific agents.

Main Results:

• 5-fluorouracil and VEGF inhibitors are linked to abnormal vasoreactivity.
• BCR-ABL inhibitors and immune checkpoint inhibitors are associated with accelerated atherosclerosis.
• VEGF inhibitors are linked to arterial aneurysms and dissections, while immune checkpoint inhibitors can cause vasculitis.

Conclusions:

• Vascular toxicities are a common adverse event in cancer treatment.
• Endothelial injury, oxidative stress, and inflammation are key mechanisms driving these complications.
• Understanding these mechanisms is vital for improving patient care and mitigating risks.