Vascular Disrupting Agents in cancer treatment: Cardiovascular toxicity and implications for co-administration with other cancer chemotherapeutics

Pharmacol Ther. 2019 Oct:202:18-31. doi: 10.1016/j.pharmthera.2019.06.001. Epub 2019 Jun 5.

Abstract

Destruction of the established tumour vasculature by a class of compound termed Vascular Disrupting Agents (VDAs) is showing considerable promise as a viable approach for the management of solid tumours. VDAs induce a rapid shutdown and collapse of tumour blood vessels, leading to ischaemia and consequent necrosis of the tumour mass. Their efficacy is hindered by the persistence of a viable rim of tumour cells, supported by the peripheral normal vasculature, necessitating their co-administration with additional chemotherapeutics for maximal therapeutic benefit. However, a major limitation for the use of many cancer therapeutics is the development of life-threatening cardiovascular toxicities, with significant consequences for treatment response and the patient's quality of life. The aim of this review is to outline VDAs as a cancer therapeutic approach and define the mechanistic basis of cardiovascular toxicities of current chemotherapeutics, with the overall objective of discussing whether VDA combinations with specific chemotherapeutic classes would be good or bad in terms of cardiovascular toxicity.

Keywords: Cancer therapy; Cardioncology; Cardiovascular toxicity; Vascular disrupting agents.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Angiogenesis Inhibitors / adverse effects*
  • Angiogenesis Inhibitors / therapeutic use*
  • Animals
  • Antineoplastic Agents / therapeutic use*
  • Cardiovascular Diseases / chemically induced*
  • Cardiovascular System / drug effects*
  • Humans
  • Neoplasms / drug therapy*
  • Neovascularization, Pathologic / drug therapy*
  • Quality of Life

Substances

  • Angiogenesis Inhibitors
  • Antineoplastic Agents