Antiplatelet and Wound Healing Implications of Immunotherapy and Targeted Cancer Therapies in the Perioperative Period

• Published in: Anesthesiology (Philadelphia) Vol. 139; no. 4; pp. 511 - 522
• Main Authors: Sindt, Jill E., Fitzgerald, Lindsey A., Kuznicki, Joanne, Prelewicz, Stacy, Odell, Daniel W., Brogan, Shane E.
• Format: Journal Article
• Language: English
• Published: 01.10.2023
• ISSN: 0003-3022; 1528-1175
• DOI: 10.1097/ALN.0000000000004669

The traditional paradigm of oncologic treatment centered on cytotoxic chemotherapy has undergone tremendous advancement during the last 15 yr with the advent of immunotherapy and targeted cancer therapies. These agents, including small molecule inhibitors, monoclonal antibodies, and immune-checkpoint inhibitors, are highly specific to individual tumor characteristics and can prevent cell growth and tumorigenesis by inhibiting specific molecular targets or single oncogenes. While generally better tolerated than traditional chemotherapy, these therapies are associated with unique constellations of adverse effects. Of particular importance in the perioperative and periprocedural settings are hematologic abnormalities, particularly antiplatelet effects with increased risk of bleeding, and implications for wound healing. This narrative review discusses targeted cancer therapies and provides recommendations for physicians managing these patients’ care as it relates to procedural or surgical interventions.