Cardiovascular Risks with Epidermal Growth Factor Receptor (EGFR) Tyrosine Kinase Inhibitors and Monoclonal Antibody Therapy

Curr Oncol Rep. 2022 Apr;24(4):475-491. doi: 10.1007/s11912-022-01215-1. Epub 2022 Feb 22.

Abstract

Purpose of review: Tyrosine kinase inhibitors (TKI) and monoclonal antibodies (mAbs) that target the epidermal growth factor receptor (EGFR) have changed the therapeutic landscape across a range of solid malignancies. However, there is little data regarding the cardiovascular (CV) impact of these agents. The purpose of this review is to discuss reported CV effects, pathophysiology, pre-treatment screening, diagnostic workup, and treatment recommendations in this patient population.

Recent findings: It is apparent that CV events are not class dependent, and while infrequently reported in clinical trials, unique CV toxicity may occur with EGFR inhibitors, including structural, electrical, and vascular events. There remains an unmet need to fully elucidate the spectrum of CV events associated with EGFR inhibitors. Early CV screening, close clinical monitoring, coupled with a multidisciplinary approach between medical and cardio-oncology is needed to minimize the potentially detrimental impact of cardiotoxicity in this patient population.

Keywords: Cancer; Cardio-oncology; Cardiovascular toxicity; EGFR mutation; Monoclonal antibody; Tyrosine kinase inhibitor.

Publication types

  • Review

MeSH terms

  • Antibodies, Monoclonal / adverse effects
  • Antineoplastic Agents* / adverse effects
  • Cardiovascular Diseases* / chemically induced
  • Cardiovascular Diseases* / drug therapy
  • ErbB Receptors
  • Heart Disease Risk Factors
  • Humans
  • Lung Neoplasms* / drug therapy
  • Mutation
  • Neoplasms* / drug therapy
  • Protein Kinase Inhibitors / adverse effects
  • Risk Factors

Substances

  • Antibodies, Monoclonal
  • Antineoplastic Agents
  • Protein Kinase Inhibitors
  • EGFR protein, human
  • ErbB Receptors