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Cancer treatment is an area of continuous improvement. Therapy is becoming more targeted
and the use of anti-angiogenic agents in multiple cancers, specifically tyrosine kinase inhibitors (TKIs),
has demonstrated prolonged survival outcomes compared with previous drugs. Therefore, they have
become a well-established part of the treatment.
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Despite good results, there is a broad range of moderate to severe adverse effects associated with treatment.
Hypertension (HTN) is one of the most frequent adverse effects and has been associated with
favourable outcomes (in terms of cancer treatment) of TKI treatment.
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High blood pressure is considered a class effect of TKI treatment, although the mechanisms have not
been fully described. Three current hypotheses of TKI-associated HTN are highlighted in this narrative
review. These include nitric oxide decrease, a change in endothelin-1 levels and capillary rarefaction.
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Several studies have investigated HTN as a potential biomarker of TKI efficacy. HTN is easy to measure
and adding this factor to prognostic models has been shown to improve specificity. HTN may become
a potential biomarker in clinical practice involving treating advanced cancers. However, data are
currently limited by the number of studies and knowledge of the mechanism of action.