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Clinical Pharmacology

Cardiovascular Safety of VEGF-Targeting Therapies: Current Evidence and Handling Strategies

Department of Medical Oncology, Bellaria-Maggiore Hospital, Bologna, Italy

Key Words. Angiogenesis • Bevacizumab • Sunitinib • Sorafenib • Cardiovascular toxicity

Correspondence: Alba A. Brandes, M.D., Department of Medical Oncology, Bellaria-Maggiore Hospital, Via Altura 3, 40139 Bologna, Italy. Telephone: 39-0-51-6225102; Fax: 39-0-51-6225057; e-mail: alba.brandes{at}yahoo.it

Received September 29, 2009; accepted for publication April 27, 2010; first published online in THE ONCOLOGIST Express on June 14, 2010.

Disclosures Fabio Girardi: None; Enrico Franceschi: None; Alba A. Brandes: Consultant/advisory role: Bristol-Myers Squibb, OncoMethylome Sciences, Roche, Schering-Plough; Honoraria: GlaxoSmithKline, Roche, Schering-Plough.

The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.

Treatment with the angiogenesis inhibitors bevacizumab, sunitinib, and sorafenib as single agents or in combination with conventional chemotherapy is becoming a cornerstone of modern anticancer therapy. However, the potential toxicity of these drugs, mainly to the cardiovascular system, is still being investigated. Patient assessment at baseline, of crucial importance in candidates for treatment, involves the evaluation of risk factors and screening for past or present cardiovascular disease. Strict monitoring of treatment-related adverse effects must be conducted in order to allow the early detection of cardiovascular toxicities and their prompt medication. In the present paper, the most frequent cardiovascular toxicities and their underlying mechanisms are investigated, with a view to providing indications for effective patient management.