The Molecular Mechanisms of Cardiotoxicity Induced by HER2, VEGF, and Tyrosine Kinase Inhibitors: an Updated Review

Cardiovasc Drugs Ther. 2022 Jun;36(3):511-524. doi: 10.1007/s10557-021-07181-3. Epub 2021 Apr 13.

Abstract

Aim: In recent decades, there has been a revolutionary decrease in cancer-related mortality and an increase in survival due to the introduction of novel targeted drugs. Nevertheless, drugs targeting human epidermal growth factor receptor 2 (HER-2), angiogenesis, and other tyrosine kinases also come with unexpected cardiac side effects, including heart failure, hypertension, arterial thrombosis, and arrhythmias, and have mechanisms that are unlike those of classic chemotherapeutic agents. In addition, it is challenging to address some problems, as the existing guidelines need to be more specific, and further large-scale clinical trials and experimental studies are required to confirm the benefit of administering cardioprotective agents to patients treated with targeted therapies. Therefore, an improved understanding of cardiotoxicity becomes increasingly important to minimize the pernicious effects and maximize the beneficial effects of targeted agents.

Methods: "Cardiotoxicity", "targeted drugs", "HER2", "trastuzumab", "angiogenesis inhibitor", "VEGF inhibitor" and "tyrosine kinase inhibitors" are used as keywords for article searches.

Results: In this article, we report several targeted therapies that induce cardiotoxicity and update knowledge of the clinical evidence, molecular mechanisms, and management measures.

Keywords: Angiogenesis inhibitors; Cardiotoxicity; Targeted drugs; Trastuzumab; Tyrosine kinase inhibitors.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Cardiotoxicity*
  • Humans
  • Protein Kinase Inhibitors / adverse effects
  • Receptor, ErbB-2 / metabolism
  • Vascular Endothelial Growth Factor A

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • Vascular Endothelial Growth Factor A
  • ERBB2 protein, human
  • Receptor, ErbB-2