ArticleESMO open2022
Major adverse cardiovascular events associated with VEGF-targeted anticancer tyrosine kinase inhibitors: a real-life study and proposed algorithm for proactive management.
Article in ESMO open, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers.
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Who cites it
33 citing papers in PubMed, 34 citations in OpenAlex.
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- Late-Onset Hypertension Is Associated With Improved Clinical Outcomes in Cancer Patients Treated With Sunitinib.Circulation reports · 2026Article
- Multimodality imaging in the detection and management of coronary and peripheral arterial disease in patients with cancer receiving cardiotoxic antineoplastic treatments: A clinical consensus statement of the ESC Council of Cardio-Oncology and the European Association of Cardiovascular Imaging (EACVI) of the ESC.European heart journal. Cardiovascular Imaging · 2026Review
- Cardiovascular Imaging for the Early Detection of Cardiotoxicity from Emerging Cancer Therapies: Mechanistic Insights Across the Pediatric and Adult Spectrum.Journal of personalized medicine · 2026Review
- Posterior Reversible Encephalopathy Syndrome with Angiogenesis Inhibitors for Solid Tumours: Clues from a Disproportionality Analysis of the FDA Adverse Event Reporting System and Pharmacodynamics.Targeted oncology · 2026Article
- Cardiovascular Risk and Prediction Model of Vascular Endothelial Growth Factor Tyrosine Kinase Inhibitors in Patients with Liver Cancer.Cardiovascular toxicology · 2026Article
- Caught in the crossfire: cardiac complications of cancer therapy.The Journal of clinical investigation · 2026Review
- Healthcare Management in Cardio-Oncology, Clinical Strategies and Future Perspectives: A Narrative Review.Healthcare (Basel, Switzerland) · 2025Review
- Thromboembolic events associated with angiogenesis inhibitors: a real-world study of data from the food and drug administration adverse event reporting system (FAERS) database.Thrombosis journal · 2025Article
- Inconsistent and Inaccurate Cancer Clinical Trial Reporting of Venous and Arterial Thrombotic Events: An Urgent Call to Action.Journal of clinical oncology : official journal of the American Society of Clinical Oncology · 2025Article
- Angiogenesis in Atrial Fibrillation: A Literature Review.Biomedicines · 2025Review
- In the Era of Cardiovascular-Kidney-Metabolic Syndrome in Cardio-Oncology: From Pathogenesis to Prevention and Therapy.Cancers · 2025Review
- Correlation between Efficacy and Cardiovascular Adverse Events in Patients with Advanced Solid Cancer Who Received VEGF Pathway Inhibitors: Hypertension within the First Eight Weeks Is Associated with Favorable Outcomes of Patients Treated with VEGF Pathway Inhibitors.Internal medicine (Tokyo, Japan) · 2025Article
- Sorafenib-to-regorafenib sequence-induced atherosclerotic cardiovascular disease: a novel case report.Frontiers in oncology · 2025Article
- Anlotinib-associated pulmonary embolism in brainstem glioblastoma treatment: a case report.Frontiers in oncology · 2025Article
- Understanding Treatment Decisions and Management for Patients with Advanced Renal Cell Carcinoma Using Hypothetical Case Studies: A Vodcast.Oncology and therapy · 2024Article
- Article
- Gastrointestinal Cancer Therapy and Cardiotoxicity.Current treatment options in oncology · 2024Review
- Arterial Thrombosis in Patients with Cancer.Cancers · 2024Review
- Cardiovascular adverse events in patients with hepatocellular carcinoma receiving vascular endothelial growth factor inhibitors.Pharmacotherapy · 2024Article
Corrections and comments
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Authors and funding
19 authors at 7 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundVascular endothelial growth factor receptor (VEGFR)-targeted tyrosine kinase inhibitors (TKIs) are widely used in cancer treatment and burdened by cardiovascular toxicity. The majority of data come from clinical trials, thus in selected populations. The aim of our study is to evaluate the cardiotoxicity profile of VEGFR-targeted TKIs and the impact of cardiovascular risk factors in a real-life population. PATIENTS AND
methodsIn this cohort, population-based study, patients treated with VEGFR-targeted TKIs, bevacizumab and trastuzumab between 2009 and 2014 were analyzed. A multi-source strategy for data retrieval through hospital, pharmaceutical and administrative databases of the Lombardy region, Italy, has been adopted. The primary endpoint was to determine the incidence and type of major adverse cardiovascular events (MACEs) along with their temporal trend. The secondary endpoint was to define the impact of cardiovascular risk factors in the occurrence of MACEs.
resultsA total of 829 patients were treated with VEGFR-targeted TKIs. Eighty-one MACEs occurred in the first year of follow-up [crude cumulative incidence (CCI): 9.79%] mainly consisting of arterial thrombotic events (ATEs, 31 events, CCI: 3.99%), followed by rhythm disorders (22 events, CCI: 2.66%), pulmonary embolisms and heart failures (13 events each, CCI: 1.57%). While the incidence of most MACEs showed a plateau after 6 months, ATEs kept increasing along the year of follow-up. Hypertension and dyslipidemia were associated with an increase in risk of ATEs [relative risk difference (RRD) +209.8% and +156.2%, respectively], while the presence of previous MACEs correlated with a higher risk of all MACEs in multivariate analysis (RRD 151.1%, 95% confidence interval 53.6% to 310.3%, P < 0.001).
conclusionsMACEs occur in a clinically significant proportion of patients treated with VEGFR-targeted TKIs, with ATEs being predominant, mainly associated with hypertension and dyslipidemia. A clinical algorithm for effective proactive management of these patients is warranted.
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