Why the study?
Fruquintinib is known to cause hypertension and cardiotoxicity, but acute aortic dissection caused by fruquintinib had not been reported.
Does fruquintinib cause acute aortic dissection in patients with metastatic colorectal cancer?
Does fruquintinib cause acute aortic dissection in patients with metastatic colorectal cancer?
This is the first reported case of acute aortic dissection associated with fruquintinib, highlighting the need for vigilance regarding severe cardiovascular toxicity with small molecular tyrosine kinase inhibitors.
First reported aortic dissection with fruquintinib; leaves open class-effect risk and need for prospective cardiovascular monitoring in VEGFR-TKI trials.
Background: Fruquintinib is a highly selective tyrosine kinase inhibitor targeting vascular endothelial growth factor receptor (VEGFR). At present, it has been approved for third-line therapy for advanced metastatic colorectal cancer in China. Like other small-molecule tyrosine kinase inhibitors, adverse reactions such as hand-foot syndrome, hypertension and cardiotoxicity may be seen. However, acute aortic dissection caused by fruquintinib has not been reported so far. Case Description: Here, we report a case of aortic dissection. The patient, a 61-year-old man with advanced metastatic colorectal cancer, without history of hypertension or other risk factors for aortic dissection, received fruquintinib as the third line of treatment. Six weeks after oral fruquintinib treatment, the patient developed acute aortic dissection, and the occurrence of the adverse effect was determined to be probably related to the use of fruquintinib. This article focuses on the potential pathogenesis of fruquintinib-induced active dissection. Conclusions: We reported the first case of fruquintinib-associated aortic dissection, and discussed the possible mechanism of vascular endothelial growth factor (VEGF)-VEGFR signal pathway (VSP) inhibitors leading to aortic dissection. As a new drug, fruquintinib brings not only clinical benefits, but also brings some adverse reactions. Clinicians must be vigilant to the cardiovascular toxicity caused by small molecular tyrosine kinase inhibitors, especially the severe cardiovascular toxicity, and strengthen monitoring and management.
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Deng et al. (2023) studied this question.
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