Vascular and cardiac complications of angiogenesis inhibitors (excluding renal effects and hemorrhagic complications)

The antiangiogenic agents are now part of themanagement of many solid tumors. They are commonly used in the treatment of digestive, kidney, breast, and lung carcinomas. Adverse events are better identified, taken into account, and managed. Of these, hypertension is the most common during the first weeks of treatment. In addition to lifestyle changes, it often requires the use of a specific treatment, which usually allows the treatment to be continued. The occurrences of thromboembolic events, especially arterial ones, are not uncommon. Better selection of patients at risk according tomedical history and underlying illness can prevent the occurrence of fatal events. The impact of antiangiogenic agents on cardiac function (isolated decrease of ejection fraction or symptomatic heart failure), though less frequent with other targeted therapies (like anti-HER2 therapies) still requires an initial assessment and regular follow-up, especially in patients with cardiac risk factors. The management of these toxicities is important to be known, and adverse reactions of such drugs should be measured and weighed against the beneficial effects expected.