Pharmacologic measures in the prevention of left ventricular dysfunction associated with molecular-targeted therapies in the treatment of cancer patients

Gil Awada, Evandro de Azambuja, Ahmad Awada

Research output: Contribution to journalScientific review

Abstract

INTRODUCTION: Left ventricular dysfunction (LVD) is an infrequent but significant side effect of certain molecular-targeted cancer therapies and may lead to treatment modification and impact on disease prognosis. There may be a role for beta blockers (BB), angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) in the prevention of LVD. Areas covered: There are multiple definitions for LVD based on clinical and/or imaging features. Molecular-targeted therapies cause reversible LVD. Therapies with well-reported LVD are inhibitors of human epidermal growth factor 2 (HER2), angiogenesis, Abelson murine leukemia viral oncogene homolog (ABL) and the proteasome. BB, ACEI and ARB seem to have a role in the prevention of LVD associated with anthracyclines. Few trials have investigated the role of BB, ACEI and ARB as primary prevention of LVD in molecular-targeted therapies. Their results are not conclusive but a beneficial role cannot be excluded. Expert opinion: Because of inconclusive data, future interventional studies should not include all treated patients with molecular-targeted therapy, but focus on patients at risk for developing LVD. Another option is to study patients who show early signs of LVD to prevent progression to overt heart failure.

Original languageEnglish
Pages (from-to)1205-1215
Number of pages11
JournalExpert Opinion On Drug Metabolism and Toxicology
Volume13
Issue number12
DOIs
Publication statusPublished - Dec 2017

Keywords

  • Adrenergic beta-Antagonists/administration & dosage
  • Angiotensin Receptor Antagonists/administration & dosage
  • Angiotensin-Converting Enzyme Inhibitors/administration & dosage
  • Animals
  • Antineoplastic Agents/administration & dosage
  • Heart Failure/etiology
  • Humans
  • Molecular Targeted Therapy/adverse effects
  • Neoplasms/drug therapy
  • Ventricular Dysfunction, Left/chemically induced

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