Tyrosine Kinase Inhibitors and Vascular Toxicity: Impetus for a Classification System?

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.

Keywords: Angina; Cancer; Cardiomyopathy; Chemotherapy; Endothelial dysfunction; Myocardial infarction; Stroke; Thrombosis; Vasospasm.