Cardiovascular side effects of small molecule therapies for cancer: Table 1

Targeted therapies such as monoclonal antibodies and small molecule inhibitors of protein kinases, have improved the prognosis for patients with a wide range of cancers. Several of these classes of therapies are associated with cardiovascular and metabolic sequelae. These include heart failure or an asymptomatic decline in ejection fraction, peripheral and cardiac ischemic events, pulmonary hypertension, arrhythmias and QT-prolongation. This review will focus on the following targeted therapies: BCR-Abl tyrosine kinase inhibitors (TKI), vascular endothelial growth factor (VEGF) signaling pathway (VSP) inhibitors as well as mitogen activated protein kinase (MEK) inhibitors and mammalian target of rapamycin complex (mTOR) inhibitors. The HER2/ErbB2 inhibitors trastuzumab and pertuzumab are important targeted therapies used in the treatment of breast cancer that have been reviewed in detail elsewhere and will not be discussed in this review.1 Table 1 summarizes the cardiovascular side effects of small molecule therapies for cancer.2 View this table: Table 1 Cardiovascular Side effects of Small Molecule Therapies for Cancer BCR-Abl tyrosine kinase inhibitors are an important advance in the treatment of chronic myelogenous leukemia (CML) and the cardiovascular side effects have been extensively reviewed by Moslehi et al.3 Imatinib, a first generation TKI was followed by the second generation TKIs nilotinib, dasatinib and bosutinib and the third-generation agent ponatinib. Imatinib has a low incidence of cardiomyopathy and heart failure, with sequential imaging studies demonstrating rates of left ventricular dysfunction comparable to expected population incidence.4 The heart failure and cardiomyopathy rates for dasatinib were similar …