Summary
Patients treated with anti-VEGF agents are at increased risk for arterial thrombo-embolic events (ATEs). However, the pathophysiology of such acute vascular complications remains unclear. We report on a case of bowel infarction in a renal cancer patient treated with the anti-VEGF agent sunitinib. An abdominal CT-scan evidenced the rupture of an atherosclerotic plaque located at the emergence of the superior mesenteric artery. In view of this report, we suggest that evaluation of the risk of ATE in patients receiving anti-VEGF agents should include not only age and past history of ATE as suggested by previous studies, but also assessment of atherosclerotic lesions on CT-scan.
References
Scappaticci FA, Skillings JR, Holden SN, Gerber HP, Miller K, Kabbinavar F, Bergsland E, Ngai J, Holmgren E, Wang J, Hurwitz H (2007) Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst 99(16):1232–1239
Choueiri TK, Schutz FA, Je Y, Rosenberg JE, Bellmunt J (2010) Risk of arterial thromboembolic events with sunitinib and sorafenib: a systematic review and meta-analysis of clinical trials. J Clin Oncol 28(13):2280–2285
Dunmore BJ, McCarthy MJ, Naylor AR, Brindle NP (2007) Carotid plaque instability and ischemic symptoms are linked to immaturity of microvessels within plaques. J Vasc Surg 45(1):155–159
Holm PW, Slart RH, Zeebregts CJ, Hillebrands JL, Tio RA (2009) Atherosclerotic plaque development and instability: a dual role for VEGF. Ann Med 41(4):257–264
Moreno PR, Purushothaman KR, Sirol M, Levy AP, Fuster V (2006) Neovascularization in human atherosclerosis. Circulation 113(18):2245–2252
Mir O, Mouthon L, Alexandre J, Mallion JM, Deray G, Guillevin L, Goldwasser F (2007) Bevacizumab-induced cardiovascular events: a consequence of cholesterol emboli syndrome? J Natl Cancer Inst 99(1):85–86
Sources of support, conflicts of interest
None.
Author information
Authors and Affiliations
Corresponding author
Additional information
Olivier Mir and François Goldwasser contributed equally to this work.
Rights and permissions
About this article
Cite this article
Ropert, S., Vignaux, O., Mir, O. et al. VEGF pathway inhibition by anticancer agent sunitinib and susceptibility to atherosclerosis plaque disruption. Invest New Drugs 29, 1497–1499 (2011). https://doi.org/10.1007/s10637-010-9500-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10637-010-9500-9