Cardiotoxic Effects of Anti-VEGFR Tyrosine Kinase Inhibitors

Angiogenesis is a key moment in tumor development and proliferation. Until recently oncologists did not know the mechanisms that were behind this phenomenon, but following the discoveries of Folkman and coworkers, they have gradually created and developed a series of drugs that act against angiogenesis by interacting with molecules belonging to the vascular endothelial growth factor (VEGFs) class and its receptors (VEGFRs) giving rise to anticancer effects. Tyrosine kinase inhibitors (TKIs) are a major class of these new anticancer agents, demonstrating high antitumor activity in a variety of "orphan" neoplasms (such as hepatocellular carcinoma, kidney cancer, sarcomas, etc.). The mechanism of action of these drugs also explains their toxicity profile with respect to the cardiovascular system. The aim of this chapter is to offer to the reader an updated overview of the new treatments available, with special attention to the assessment and management of cardiovascular side effects.