Cardiovascular Toxicity and Sorafenib

Abstract

We report a case of a 55-year-old male with chronic hepatitis C virus infection and compensated liver disease treated with sorafenib for advanced hepatocarcinoma (Barcelona Clinic Liver Cancer stage C). At follow-up, the patient developed hypertension, which was well controlled with beta-blocker medication, and an aortic dilation detected by abdominal computerized tomography and echocardiography. There are some reports of the side effects of sorafenib on the cardiovascular system. The patient had no cardiac or aortic pathology before the start of this palliative chemotherapy. There is an article that describes the development of an aortic aneurysm in a patient with uncontrolled hypertension, who received treatment with sorafenib for renal carcinoma. However, our patient had a good control of blood pressure. The adverse vascular effects of Sorafenib may be due to the inhibition of the proliferation of vascular endothelial muscle cells. We believe that this case illustrates a probable relationship between sorafenib and aortic dilatation according to the Karch and Lasagna causality algorithm.

Examining the Effects of Dasatinib, Sorafenib, and Nilotinib on Vascular Smooth Muscle Cells: Insights into Proliferation, Migration, and Gene Expression Dynamics

“…Accordingly, a case-report study published in 2014 showed that the patient treated with sorafenib developed hypertension and an aortic dilation detected by abdominal computerized tomography and echocardiography. Which was well controlled with β-blocker medication [ 12 ]. Also, in this observational, single-center study of 74 patients using either sorafenib or sunitinib, 33.8% had a cardiac event, 40.5% had ECG changes, 18% were symptomatic, and 9.4% of these patients were seriously compromised and required intensive care admission, so careful cardiovascular monitoring should be considered [ 13 ].…”