Acute blood pressure elevation associated with biological therapies for cancer: a focus on VEGF signaling pathway inhibitors

Effects of Camrelizumab Combined with First-Line Chemotherapy on Serum SCC, VEGF Levels, and Adverse Reactions in Patients with Advanced Squamous Cell Carcinoma of the Lung

“…Te combination of the GP As a tissue-specifc glycoprotein tumor marker for squamous carcinoma, the level of SCC increases along with the aggravation of squamous carcinoma, which has positive signifcance for clinical assessment of the efcacy, prognosis, and recurrence of squamous carcinoma patients [22]. VEGF is a provascular endothelial growth factor induced by hypoxia, which can increase vascular permeability by binding to vascular endothelial cell receptors, induce endothelial cell proliferation as well as promote stromal lysis and infammatory exudation, and accelerate the proliferation of tumor cells, therefore, the proliferation and diferentiation of tumor cells can be reduced by inhibiting the expression of VEGF, which facilitates clinical treatment [23]. Ma [24] found that inhibition of VEGF expression could inhibit NSCLC angiogenesis.…”

Cardiovascular Toxicity Induced by Vascular Endothelial Growth Factor Inhibitors

“…ACE inhibitors, angiotensin receptor blockers (ARBs) and non-dihydropiridine Ca 2+ -channel blockers are first-line treatments [ 4 , 16 , 18 ]. In patients with heart failure or cardiac dysfunction, ACE inhibitors and beta-blockers are the recommended antihypertensive drugs [ 4 , 19 ]. Of beta blockers, nebivolol is an important option due to its additional effect of increasing NO release, blocked by VEGF inhibitors therapy [ 3 ].…”

“…Of beta blockers, nebivolol is an important option due to its additional effect of increasing NO release, blocked by VEGF inhibitors therapy [ 3 ]. As NO donors, nitroglycerin and sodium nitroprusside are preferred intravenous drugs for hypertensive emergencies [ 19 ]. Diltiazem and verapamil should be avoided due to interaction with VEGF inhibitors in cytochrome P4503A4, resulting in increased plasma levels of antineoplastic drugs [ 3 , 6 ].…”

“…Arterial thrombosis appears in only 1% of cancer patients [ 3 , 19 ]. However, in metastatic pancreatic, breast, lung or colorectal neoplasms treated with VEGF inhibitors, anthracyclines or taxanes, the incidence of arterial thrombosis increases significantly and it is associated with a poor prognosis [ 3 , 17 ].…”

“…The risk factors, mechanisms and management for cerebrovascular events are the same as for myocardial ischemia due to VEGF inhibitors, presented above. Compared to cardiac thrombosis, cerebrovascular disease secondary to VEGF-TKIs is rare, with a mean incidence of 0.5% for ischemic stroke and 0.3% for hemorrhagic events [ 17 , 19 ]. The highest incidence was found for cediranib (3.2%) and pazopanib (2.4%) [ 18 , 44 ].…”