Hypertension in cancer patients treated with anti-angiogenic based regimens

Wasserstrum, Yishay; Kornowski, Ran; Raanani, Pia; Leader, Avi; Pasvolsky, Oren; Iakobishvili, Zaza

doi:10.1186/s40959-015-0009-4

Cited by 28 publications

(27 citation statements)

References 121 publications

(135 reference statements)

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“…40,41 A combination of β-blockers and hydra-lazine may also be used to manage pazopanib-induced HTN, especially for patients with left ventricular dysfunction or arrhythmia. 25,42 More prospective clinical studies are needed in order to develop evidence-based treatment guidelines for managing pazopanib-induced HTN.…”

Section: Specific Cardiovascular Adverse Effects Associated With Pazomentioning

confidence: 99%

The Impact of Pazopanib on the Cardiovascular System

Justice

Derbala

Baich

et al. 2018

J Cardiovasc Pharmacol Ther

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Pazopanib is an approved treatment for renal cell carcinoma and a second-line treatment for nonadipocytic soft-tissue sarcoma. However, its clinical efficacy is limited by its cardiovascular side effects. Pazopanib and other vascular endothelial growth factor receptor tyrosine kinase inhibitors have been associated with the development of hypertension, QT interval prolongation, and other cardiovascular events; however, these mechanisms are largely unknown. Gaining a deeper understanding of these mechanisms is essential for the development of appropriate surveillance strategies and possible diagnostic biomarkers to allow us to monitor patients and modulate therapy prior to significant cardiac insult. This approach will be vital in keeping patients on these life-saving therapies and may be applicable to other tyrosine kinase inhibitors as well. In this review, we provide a comprehensive overview of the preclinical and clinical side effects of pazopanib with a focus on the mechanisms responsible for its toxicity to the cardiovascular system.

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Section: Specific Cardiovascular Adverse Effects Associated With Pazomentioning

confidence: 99%

The Impact of Pazopanib on the Cardiovascular System

Justice

Derbala

Baich

et al. 2018

J Cardiovasc Pharmacol Ther

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“…Ha sido documentado que los pacientes que desarrollan HTA tienen mejor respuesta al tratamiento con estas drogas y mayor sobrevida (17,18) . En una serie retrospectiva de casi 5.000 pacientes tratados con sunitinib para carcinoma de células renales en etapa metastásica, los que desarrollaron HTA tuvieron una sobrevida promedio cuatro veces mayor (30,9 meses contra 7,2 meses) (19) .…”

Section: Inhibidores De Tirosina Quinasaunclassified

“…Cuanto más potente la inhibición de la vía de señalización de VEGF, mayor el potencial hipertensivo, por lo que el mismo es más frecuente y severo con las drogas de introducción más reciente (axitinib, regorafenib y lenvatinib) (18) .…”

Section: Magnitud Del Efecto Pro Hipertensivo De Las Drogas Inhibidorunclassified

Hipertensión arterial y tratamiento del cáncer

Paganini

2018

Rev.Urug.Cardiol.

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ResumenLa hipertensión arterial (HTA) tiene alta prevalencia y es la comorbilidad más frecuente al momento del diagnóstico de cáncer. La nueva aparición o el agravamiento de la HTA durante el tratamiento oncológico es también común, sobre todo durante los períodos de quimioterapia. Si bien varias drogas utilizadas en quimioterapia tienen potencial pro hipertensivo, los fármacos inhibidores de la angiogénesis tienen un efecto de clase sobre la presión arterial (PA) y son los que plantean mayores problemas al médico. Los tratamientos de sostén también pueden incrementar la PA, sobre todo la eritropoyetina, los antiinflamatorios no esteroideos y los corticoesteroides. No existe una guía específica basada en evidencia para el manejo de la HTA durante el tratamiento del cáncer, por tanto se revisan las recomendaciones de expertos para enfrentar este problema frecuente. Palabras clave: Hypertension and cancer treatment SummaryHypertension is highly prevalent and the most frequent comorbidity at the initial diagnosis of cancer. New onset or worsening hypertension is also common during cancer treatment, in particular during chemotherapy periods. Several drugs used in chemotherapy could have an hypertensive effect, for instance angiogenesis inhibitors have a class effect on blood pressure and frequently clinicians confront this problem. Adjuvant drugs in cancer treatment could also increase blood pressure, especially erythropoietin, non-steroidal anti-inflammatory drugs and corticosteroids. There are not specific evidence based guidelines for the management of hypertension during cancer treatment, for that reason we review expert suggestions to deal with this frequent issue. Key words: HYPERTENSION NEOPLASMS CHEMOTHERAPY ANGIOGENESIS INHIBITORS I. Convergencia epidemiológicaLa prevalencia promedio de hipertensión arterial (HTA) en la población adulta (mayor de 25 años) de las Américas ha sido estimada en 35%, según un reporte de la Organización Mundial de la Salud del año 2013 (1) . Esta prevalencia es creciente con la edad, por lo que se encuentra presente en la mayoría de las personas que tienen más de 60 años. La prevalencia de cáncer también aumenta con la edad y comparte varios factores de riesgo con la enfermedad cardiovascular (tabaco, dieta inadecuada, obesidad, sedentarismo). La HTA constituye la comorbilidad más frecuente entre los pacientes con diagnóstico inicial de cán-cer, con una prevalencia que se ha estimado próxima a 40% o mayor en esa población (2)(3)(4) . Asimismo, estudios epidemiológicos recientes ajustados por edad y otras variables han encontrado un riesgo aumentado de cáncer y de mortalidad por esta causa entre los pacientes hipertensos (5,6) .La aparición de nuevos casos de HTA o el agravamiento de la misma en quienes ya la padecen es muy común durante el tratamiento del cáncer. En un estudio retrospectivo de más de 25.000 pacientes con varios tipos de cáncer, que registraron una presión arterial (PA) normal al momento del diagnóstico (independientemente de sus anteceden- 43MP Medicina Personali...

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“…Studies have shown that dihydropyridine CCBs, such as amlodipine, have a great effect on relaxing smooth muscle cells and thereby lowering the total periphery resistance and hence the blood pressure. ACEi and AIIA have also shown good results in the antihypertensive treatment and concurrent renal-protecting effects in these treated cancer patients [39,50]. …”

Section: Introductionmentioning

confidence: 99%

The Adverse Effect of Hypertension in the Treatment of Thyroid Cancer with Multi-Kinase Inhibitors

Ancker

Wehland

Bauer

et al. 2017

IJMS

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Abstract:The treatment of thyroid cancer has promising prospects, mostly through the use of surgical or radioactive iodine therapy. However, some thyroid cancers, such as progressive radioactive iodine-refractory differentiated thyroid carcinoma, are not remediable with conventional types of treatment. In these cases, a treatment regimen with multi-kinase inhibitors is advisable. Unfortunately, clinical trials have shown a large number of patients, treated with multi-kinase inhibitors, being adversely affected by hypertension. This means that treatment of thyroid cancer with multi-kinase inhibitors prolongs progression-free and overall survival of patients, but a large number of patients experience hypertension as an adverse effect of the treatment. Whether the prolonged lifetime is sufficient to develop sequelae from hypertension is unclear, but late-stage cancer patients often have additional diseases, which can be complicated by the presence of hypertension. Since the exact mechanisms of the rise of hypertension in these patients are still unknown, the only available strategy is treating the symptoms. More studies determining the pathogenesis of hypertension as a side effect to cancer treatment as well as outcomes of dose management of cancer drugs are necessary to improve future therapy options for hypertension as an adverse effect to cancer therapy with multi-kinase inhibitors.

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Hypertension in cancer patients treated with anti-angiogenic based regimens

Cited by 28 publications

References 121 publications

The Impact of Pazopanib on the Cardiovascular System

The Impact of Pazopanib on the Cardiovascular System

Hipertensión arterial y tratamiento del cáncer

The Adverse Effect of Hypertension in the Treatment of Thyroid Cancer with Multi-Kinase Inhibitors

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