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VEGF Receptor Inhibitor-Induced Hypertension: Emerging Mechanisms and Clinical Implications

  • Cardio-oncology (JN Upshaw, Section Editor)
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Abstract

Purpose of Review

While vascular endothelial growth factor receptor inhibitors (VEGFRis) have dramatically improved cancer survival, these drugs cause hypertension in a majority of patients. This side effect is often dose limiting and increases cardiovascular mortality in cancer survivors. This review summarizes recent advances in our understanding of the molecular mechanisms and clinical findings that impact management of VEGFRi-induced hypertension.

Recent Findings

Recent studies define new connections between endothelial dysfunction and VEGFRi-induced hypertension, including the balance between nitric oxide, oxidative stress, endothelin signaling, and prostaglandins and the potential role of microparticles, vascular smooth muscle cells, vascular stiffness, and microvessel rarefaction. Data implicating genetic polymorphisms that might identify patients at risk for VEGFRi-induced hypertension and the growing body of literature associating VEGFRi-induced hypertension with antitumor efficacy are reviewed.

Summary

These recent advances have implications for the future of cardio-oncology clinics and the management of VEGFRi-induced hypertension.

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Funding

This work was supported by grants from the NIH (CA243542 to IZJ and CL and HL155078 to IZJ).

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Author notes

  1. Nicholas Camarda and Richard Travers contributed equally to this work.

Authors and Affiliations

  1. Molecular Cardiology Research Institute, Tufts Medical Center, 800 Washington Street, Box 80, Boston, MA, 02111, USA

    Nicholas Camarda, Richard Travers & Iris Z. Jaffe

  2. Department of Medicine, Division of Hematology Oncology, Tufts Medical Center, MA, Boston, USA

    Richard Travers

  3. Cummings School of Veterinary Medicine, Tufts University, MA, Boston, USA

    Vicky K. Yang & Cheryl London

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Correspondence to Iris Z. Jaffe.

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Camarda, N., Travers, R., Yang, V.K. et al. VEGF Receptor Inhibitor-Induced Hypertension: Emerging Mechanisms and Clinical Implications. Curr Oncol Rep 24, 463–474 (2022). https://doi.org/10.1007/s11912-022-01224-0

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