Risk of cardiovascular toxicities in patients with solid tumors treated with sunitinib, axitinib, cediranib or regorafenib: An updated systematic review and comparative meta-analysis

Abdel‐Rahman, Omar; Fouad, Mona

doi:10.1016/j.critrevonc.2014.06.003

Cited by 53 publications

(31 citation statements)

References 37 publications

(17 reference statements)

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“…A meta-analysis of four phase II and phase III trials of cediranib indicated increased risk of all-grade hypertension in 42.1 % of cases (RR 2.63, 95 % CI 1.61 to 4.29, p < 0.001) [23]. No data on high-grade hypertension was available in this study.…”

Section: Cediranibcontrasting

confidence: 40%

“…This concept is further supported by evidence that bevacizumab, a monoclonal anti-VEGF-A antibody, and aflibercept, a soluble receptor with affinity to VEGF-A and -B, are also strong inducers of hypertension [20,21]. Inhibition of the VEGF pathway induces hypertension as a class effect; VEGFR-2 is most prominent of those [22][23][24].…”

Section: Pathogenesis Of Hypertension Secondary To Vsp Inhibitionmentioning

confidence: 50%

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Hypertension in cancer patients treated with anti-angiogenic based regimens

et al. 2015

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New anti-cancer drugs that inhibit the vascular endothelial growth factor (VEGF) signaling pathway are highly effective in the treatment of solid tumors, however concerns remain regarding their cardiovascular safety. The most common side effect of VEGF signaling pathway (VSP) inhibition is the development of systemic hypertension. We review the incidence, possible mechanisms, significance and management of hypertension in patients treated with VSP inhibitors.

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Section: Cediranibcontrasting

confidence: 40%

Section: Pathogenesis Of Hypertension Secondary To Vsp Inhibitionmentioning

confidence: 50%

Hypertension in cancer patients treated with anti-angiogenic based regimens

et al. 2015

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“…38 Similarly, a meta-analysis of Phase II and Phase III trials of several oral multikinase inhibitors (including four trials with axitinib) reported a significantly increased risk of all-grade hypertension with the use of these agents. 39 However, no significantly increased risk was observed with axitinib relative to the other included agents. 39 As treatment-induced hypertension may lead to serious end-organ effects and/or the interruption of effective cancer therapy, blood pressure should be monitored carefully, with the prompt initiation of antihypertensive medications as necessary.…”

mentioning

confidence: 79%

“…39 However, no significantly increased risk was observed with axitinib relative to the other included agents. 39 As treatment-induced hypertension may lead to serious end-organ effects and/or the interruption of effective cancer therapy, blood pressure should be monitored carefully, with the prompt initiation of antihypertensive medications as necessary. Although the exact mechanisms of VEGF-inhibitorrelated hypertension remain unclear, it is hypothesized that an increase in systemic vascular resistance results from decreased nitric oxide production, vascular rarefaction, and the secretion of neurohormonal vasoconstrictive factors (including endothelin 1).…”

mentioning

confidence: 79%

Axitinib in the treatment of renal cell carcinoma: patient selection and perspectives

Narayan

Haas

2016

IJNRD

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Background: Axitinib is a next-generation, selective tyrosine kinase inhibitor targeting the vascular endothelial growth factor receptors. It is approved for the treatment of metastatic renal cell carcinoma (mRCC) based on a demonstrated progression-free survival advantage over sorafenib in the second-line treatment setting. However, given the variety of available targeted therapies for mRCC, appropriate patient selection for the available therapies remains a significant clinical challenge. Purpose: This review summarizes the available evidence on the clinical, toxicity, and pharmacologic considerations for determining appropriate patient selection for axitinib therapy. In addition, it describes recent data on the use of predictive biomarkers to guide clinical management. This paper consists of material obtained via PubMed and Medline literature searches through October 2015. Conclusion: Axitinib has a well-established role in the management of mRCC. Consistent clinical efficacy has been demonstrated across prognostic risk groups and prior therapeutic exposures. Although axitinib is generally well tolerated, appropriate toxicity management is critical to maximizing drug delivery and optimizing treatment outcomes. Although incident hypertension has been associated with improved clinical outcomes on axitinib, there are currently no validated clinical or genetic predictive biomarkers to guide patient selection.

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“…One of the most important long-term toxicities experienced by cancer survivors is cardiac toxicity so that the survival benefit due to anticancer therapy might be compromised by increased mortality due to cardiac complications [4].…”

mentioning

confidence: 99%

Use of angiotensin-converting enzyme inhibitors in the prophylaxis of anthracycline or trastuzumab-related cardiac dysfunction: preclinical and clinical considerations

Abdel‐Rahman

Alorabi

2015

Expert Review of Anticancer Therapy

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Cardiac toxicity is one of the most important long-term toxicities experienced by cancer survivors so that survival rate due to anticancer therapy may be negatively affected due to cardiac complications. Thus, the search for novel methods to lower the incidence of treatment-related cardiotoxicity is a priority for all cancer-related disciplines. In this review, we provide an overview of the available preclinical and clinical data evaluating the role of angiotensin-converting enzyme inhibitors in the prophylaxis of cardiac dysfunction secondary to anthracyclines and trastuzumab use. The available clinical data suggest some degree of protective utility for the use of some angiotensin-converting enzyme inhibitors against anthracycline-related cardiotoxicity while the data are scarce with regard to a similar role for patients receiving trastuzumab.

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Risk of cardiovascular toxicities in patients with solid tumors treated with sunitinib, axitinib, cediranib or regorafenib: An updated systematic review and comparative meta-analysis

Cited by 53 publications

References 37 publications

Hypertension in cancer patients treated with anti-angiogenic based regimens

Hypertension in cancer patients treated with anti-angiogenic based regimens

Axitinib in the treatment of renal cell carcinoma: patient selection and perspectives

Use of angiotensin-converting enzyme inhibitors in the prophylaxis of anthracycline or trastuzumab-related cardiac dysfunction: preclinical and clinical considerations

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