Large artery stiffness and hypertension after antiangiogenic drugs

Alivon, Maureen; Giroux, Julie; Briet, Marie; Goldwasser, François; Laurent, Stéphane; Boutouyrie, Pierre

doi:10.1097/hjh.0000000000000550

Cited by 30 publications

(30 citation statements)

References 51 publications

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“…This observation could be related to the recent finding that the baseline increase of aortic stiffness, a condition associated with age, was predictive of the risk of HTN in patients receiving a VEGF-inhibiting drug. 19 By contrast, in the subgroup of patients without prior HTN, the incidence of severe HTN was not related to age.…”

Section: Discussionmentioning

confidence: 92%

A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma

Beinse¹,

Emile²,

Cessot³

et al. 2016

Int J Gynecol Cancer

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Section: Discussionmentioning

confidence: 92%

A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma

Beinse¹,

Emile²,

Cessot³

et al. 2016

Int J Gynecol Cancer

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“…Another suggestion was damage to the vasa-vasorum, which has been linked with PWV increases. 28 Although this study was small and featured pooled results, increases in arterial stiffness have been suggested elsewhere as a class effect of anti-angiogenic medications. 29 …”

Section: Selected Tkismentioning

confidence: 76%

Mechanisms, monitoring, and management of tyrosine kinase inhibitors-associated cardiovascular toxicities

Chaar

Kamta

Ait‐Oudhia

2018

OTT

103

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The tyrosine kinase inhibitor (TKI) drug class is a prominently used option in the treatment of various cancers. Safety evaluation of these drugs has shown evidence of cardiotoxicity of varying frequency and severity between agents; concern has led to updated labeling, warning prescribers of such. This review seeks to clarify the present dangers and investigate cardiotoxic mechanisms of action for each discussed TKI. Dasatinib was connected primarily with an incidence of fluid retention, edema, QT prolongation, and pulmonary hypertension in clinical studies. It is theorized that this is due to a combination of off-target kinase binding and on-target binding of Bcr-Abl, and less likely, mitochondrial induced apoptosis. Studies showed sorafenib to carry the risk of hypertension, QT prolongation, and myocardial infarction. Proposed mechanisms for these side effects include inhibition of proteins, vascular endothelium growth factor receptor, hERG potassium channels, and the RAF/MERK/ERK pro-survival pathway. Finally, lapatinib showed evidence of decreased left ventricular ejection fraction (LVEF) and QT prolongation in clinical studies. The literature attributes these as side effects of on-target ErbB2 binding leading to mitochondrial induced apoptosis. The concern warranted by these findings is in question. Pooled safety data suggest that the overall risk for cardiotoxicity is minimal in dasatinib and lapatinib. Sorafenib seems to carry a moderate concern. For the discussed agents, recommendations agree that routine monitoring via methods such as electroencephalogram, cardiac biomarkers, and blood pressure is warranted during the course of treatment, in addition to a comprehensive collection of past medical history and risk factors to identify those at heightened risk for cardiovascular events.

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“… 20 – 22 Cardiovascular events are frequent with VEGFR-TKI and can be severe. 23 , 24 Hypertension is common during axitinib treatment. It was the first dose-limiting toxicity in the Phase I study, and hypertension was reported in 40.4% of treated patients in the Phase III AXIS trial, with 15.6% of grade 3–4 hypertension.…”

Section: Toxicitymentioning

confidence: 99%

Axitinib in the treatment of renal cell carcinoma: design, development, and place in therapy

Bellesœur¹,

Carton²,

Alexandre³

et al. 2017

DDDT

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Since 2005, the approved first-line treatment of metastatic renal cell carcinoma consists in tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor receptors (VEGFRs). Axitinib is an oral second-generation TKI and a potent VEGFR inhibitor with a half maximal inhibitory concentration for the VEGF family receptors 10-fold lower than other TKIs. Axitinib activity in renal cell carcinoma (RCC) patients has been studied in various settings and particularly as second-line treatment. In this setting, axitinib with clinically based dose escalation compared to sorafenib has demonstrated an improvement in progression-free survival in a randomized Phase III trial leading to US Food and Drug Administration approval. In the first-line setting, axitinib failed to demonstrate improved efficacy over sorafenib, but the field of RCC treatment is rapidly changing with novel TKIs as cabozantinib or the emergence of check point inhibitors as nivolumab and the place of axitinib in therapy is therefore challenged. In this review, we focus on axitinib pharmacological and clinical properties in RCC patients and discuss its place in the treatment of patients with RCC.

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Large artery stiffness and hypertension after antiangiogenic drugs

Cited by 30 publications

References 51 publications

A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma

A Real-Life Experience of Bevacizumab in Elderly Women With Advanced Ovarian Carcinoma

Mechanisms, monitoring, and management of tyrosine kinase inhibitors-associated cardiovascular toxicities

Axitinib in the treatment of renal cell carcinoma: design, development, and place in therapy

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