Systemic therapies for non-small-cell lung cancer are associated with various cardiovascular complications, including venous thromboembolism in up to 15% of patients, arrhythmias, and heart failure.
Awareness of specific cardiovascular complications associated with different NSCLC therapies is crucial for early diagnosis and management in cardio-oncology.
Cardiovascular diseases may determine therapy outcomes of non-small-cell lung cancer (NSCLC). The evidence for how iatrogenic cardiovascular complications contribute to ceasing anticancer treatment, decreasing the quality of life or even premature death, is unclear. Older patients and smokers are at risk of atherosclerosis and arterial thromboembolic events (TE), such as myocardial infarction or stroke. Venous TE can be observed in up to 15% of NSCLC patients, but the risk increases three to five times in ALK (anaplastic lymphoma kinase)-rearranged NSCLC. ALK inhibitors are associated with electrophysiological disorders. Cytotoxic agents and anti-VEGF inhibitors mainly cause vascular complications, including venous or arterial TE. Cardiac dysfunction and arrhythmias seem to be less frequent. Chemotherapy is often administered in two-drug regimens. Clinical events can be triggered by different mechanisms. Among epidermal growth factor inhibitors, erlotinib and gefitinib can lead to coronary artery events; however, afatinib and osimertinib can be associated with the development of heart failure. During anti-PD1/anti-PDL1 therapy, myocarditis is possible, which must be differentiated from acute coronary syndrome and heart failure. Awareness of all possible cardiovascular complications in NSCLC encourages vigilance in early diagnostics and treatment.
Zaborowska-Szmit et al. (Mon,) conducted a review in Non-small-cell lung cancer (NSCLC). Systemic therapy (ALK inhibitors, cytotoxic agents, anti-VEGF, EGFR inhibitors, anti-PD1/PDL1) was evaluated. Systemic therapies for non-small-cell lung cancer are associated with various cardiovascular complications, including venous thromboembolism in up to 15% of patients, arrhythmias, and heart failure.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: