Effects of Cancer Therapy Targeting Vascular Endothelial Growth Factor Receptor on Central Blood Pressure and Cardiovascular System.

Abstract

BACKGROUND:

In the last 2 decades, new drugs that oppose the effects of vascular endothelial growth factor receptor (VEGFR), and thus angiogenesis, have considerably improved treatment of solid tumors. These anti-VEGFR drugs, however, are burdened by several side effects, particularly relevant on heart and vessels. The aim of this study was to analyze the changes in cardiovascular structure and function associated with use of anti-VEGFR drugs.

METHODS:

Twenty-nine patients (27 affected by renal and 2 by thyroid cancer), received treatment with anti-VEGFR drugs. Brachial blood pressure (BP), central BP, carotid-femoral pulse wave velocity (cfPWV), augmentation index (Aix), and several echocardiographic markers of systolic and diastolic left ventricular functions including global longitudinal strain were measured before starting treatment (T0), after 2 (T1), and 6 weeks (T2) of treatment.

RESULTS:

Anti-VEGFR treatment was accompanied by a significant increase of both peripheral (systolic BP +13±15.5mm Hg, diastolic BP +7.1±9.3mm Hg, P < 0.001) and central BP (systolic BP +14±14.2mm Hg, diastolic BP +7.3±10.4mm Hg, P < 0.001) and a significant raise of cfPWV (+1.3±1.8 m/sec, P = 0.003). There was also a significant alteration of markers of diastolic and subclinical left ventricular systolic function, including global longitudinal strain (-19.9±3.8% at T0, -17.8±2.6% at T2, P < 0.05). All the changes were already evident at T1, worsened at T2 in patients who maintained oncological treatment, but disappeared at T2 in patients in whom treatment was stopped.

CONCLUSIONS:

All the changes regarding BP and cfPWV appear early after treatment initiation and seem to be reversible if treatment is stopped, instead diastolic and systolic left ventricular function are persistently altered by anti-VEGFR drugs.

• Authors: Antonella Moreo, Paola Vallerio, Riccardo Ricotta, Miriam Stucchi, Mattia Pozzi, Francesco Musca, Paolo Meani, Alessandro Maloberti, Rita Facchetti, Sara Di Bella, Maria Olga Giganti, Andrea Sartore-Bianchi, Salvatore Siena, Giuseppe Mancia, Cristina Giannattasio
• Journal: American journal of hypertension (Am J Hypertens) Vol. 29 Issue 2 Pg. 158-62 (Feb 2016) ISSN: 1941-7225 [Electronic] United States
• PMID: 26031304 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © American Journal of Hypertension, Ltd 2015. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Antineoplastic Agents
• Indazoles
• Indoles
• Phenylurea Compounds
• Pyrimidines
• Pyrroles
• Sulfonamides
• Niacinamide
• pazopanib
• Sorafenib
• Receptors, Vascular Endothelial Growth Factor
• Sunitinib

Topics

• Aged
• Antineoplastic Agents (adverse effects)
• Arteries (drug effects)
• Blood Pressure (drug effects)
• Carcinoma, Renal Cell (drug therapy)
• Female
• Heart (drug effects)
• Humans
• Indazoles
• Indoles (adverse effects)
• Kidney Neoplasms (drug therapy)
• Male
• Middle Aged
• Niacinamide (adverse effects, analogs & derivatives)
• Phenylurea Compounds (adverse effects)
• Pulse Wave Analysis
• Pyrimidines (adverse effects)
• Pyrroles (adverse effects)
• Receptors, Vascular Endothelial Growth Factor (antagonists & inhibitors)
• Sorafenib
• Sulfonamides (adverse effects)
• Sunitinib
• Thyroid Neoplasms (drug therapy)
• Vascular Stiffness (drug effects)