Anticancer therapy-induced vascular toxicity: VEGF inhibition and beyond

Cardiotoxicity induced by chemotherapeutic agents and radiotherapy is a growing
problem. In recent years, an increasing number of new drugs with targeted action have
been designed. These molecules, such as monoclonal antibodies and tyrosine kinase
inhibitors, can cause different type of toxicities compared to traditional chemotherapy.
However, they can also cause cardiac complications such as heart failure, arterial
hypertension, QT interval prolongation and arrhythmias. Currently, a field of intense
research is the vascular toxicity induced by new biologic drugs, particularly those which
inhibit vascular endothelial growth factor (VEGF) and its receptor (VEGF-R) and other
tyrosine kinases. In this review, we aim at focusing on the problem of vascular toxicity
induced by new targeted therapies, chemotherapy and radiotherapy, and describe the
main mechanisms and emphasizing the importance of early diagnosis of vascular damage,
in order to prevent clinical complications.