Cardiotoxicity Induced by Protein Kinase Inhibitors in Patients with Cancer

Int J Mol Sci. 2022 Mar 4;23(5):2815. doi: 10.3390/ijms23052815.

Abstract

Kinase inhibitors (KIs) represent a growing class of drugs directed at various protein kinases and used in the treatment of both solid tumors and hematologic malignancies. It is a heterogeneous group of compounds that are widely applied not only in different types of tumors but also in tumors that are positive for a specific predictive factor. This review summarizes common cardiotoxic effects of KIs, including hypertension, arrhythmias with bradycardia and QTc prolongation, and cardiomyopathy that can lead to heart failure, as well as less common effects such as fluid retention, ischemic heart disease, and elevated risk of thromboembolic events. The guidelines for cardiac monitoring and management of the most common cardiotoxic effects of protein KIs are discussed. Potential signaling pathways affected by KIs and likely contributing to cardiac damage are also described. Finally, the need for further research into the molecular mechanisms underlying the cardiovascular toxicity of these drugs is indicated.

Keywords: cancer; cardiotoxicity; molecular mechanisms of cardiac damage; protein kinase inhibitors; targeted treatment.

Publication types

  • Review

MeSH terms

  • Antineoplastic Agents* / adverse effects
  • Arrhythmias, Cardiac
  • Cardiotoxicity / drug therapy
  • Heart
  • Heart Failure*
  • Humans
  • Neoplasms* / drug therapy
  • Protein Kinase Inhibitors / adverse effects

Substances

  • Antineoplastic Agents
  • Protein Kinase Inhibitors