Endothelial vascular toxicity from chemotherapeutic agents: Preclinical evidence and clinical implications
In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician’s therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently conside...
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| Published in | Cancer treatment reviews Vol. 38; no. 5; pp. 473 - 483 |
|---|---|
| Main Authors | , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Netherlands
Elsevier Ltd
01.08.2012
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| Subjects | |
| Online Access | Get full text |
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| Abstract | In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician’s therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called “accidental” anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer. |
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| AbstractList | In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician's therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called "accidental" anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer.In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician's therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called "accidental" anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer. In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinicianas therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called aaccidentala anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer. In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician's therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called "accidental" anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer. Abstract In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new treatment strategy was added in the clinician’s therapeutic armamentarium. On the other hand, numerous classic cytotoxic agents are currently considered as potential angiogenesis inhibitors, although they were not originally developed as such, representing the so-called “accidental” anti-angiogenic drugs. The discovery of these new properties of classic cytotoxic agents led to the re-evaluation of their effect on vascular cells, rendering thus the endothelium an appealing target for therapeutic intervention, either with chemotherapy alone or with combination of cytotoxics with molecular angiogenesis inhibitors. Moreover, current evidence supports that chemotherapy-induced endothelial dysfunction constitutes an integrating predictive marker of future cardiovascular events and correlates well with traditional cardiovascular risk factors. It has therefore been suggested that evaluation of endothelial function may be useful in identifying asymptomatic subjects at high risk for cardiovascular events as well as for risk stratification of patients with established cardiovascular disease. Integration of the assessment of endothelial function in the clinical setting will thus enable effective intervention strategies to prevent or minimize the impact of these late adverse effects and design accurate follow-up protocols focused on cardiovascular complications. In the current review we provide a comprehensive overview of the effects of cytotoxic chemotherapeutic agents on endothelial function and the clinical implications of chemotherapy-associated endothelial toxicity in patients with cancer. |
| Author | Mountzios, Giannis Soultati, Aspasia Pectasides, Dimitrios Dimopoulos, Meletios-Athanassios Avgerinou, Chrysoula Papaxoinis, George Papadimitriou, Christos |
| Author_xml | – sequence: 1 givenname: Aspasia surname: Soultati fullname: Soultati, Aspasia organization: Department of Medical Oncology and Translational Research, 251 General Airforce Hospital, Athens, Greece – sequence: 2 givenname: Giannis surname: Mountzios fullname: Mountzios, Giannis email: gmountzios@med.uoa.gr organization: Department of Medical Oncology and Translational Research, 251 General Airforce Hospital, Athens, Greece – sequence: 3 givenname: Chrysoula surname: Avgerinou fullname: Avgerinou, Chrysoula organization: Oncology Unit, Department of Clinical Therapeutics, University of Athens School of Medicine, “Alexandra” Hospital, Athens, Greece – sequence: 4 givenname: George surname: Papaxoinis fullname: Papaxoinis, George organization: Oncology Unit, 2nd Department of Internal Medicine, University of Athens School of Medicine, “Hippocration” Hospital, Athens, Greece – sequence: 5 givenname: Dimitrios surname: Pectasides fullname: Pectasides, Dimitrios organization: Oncology Unit, 2nd Department of Internal Medicine, University of Athens School of Medicine, “Hippocration” Hospital, Athens, Greece – sequence: 6 givenname: Meletios-Athanassios surname: Dimopoulos fullname: Dimopoulos, Meletios-Athanassios organization: Oncology Unit, Department of Clinical Therapeutics, University of Athens School of Medicine, “Alexandra” Hospital, Athens, Greece – sequence: 7 givenname: Christos surname: Papadimitriou fullname: Papadimitriou, Christos organization: Oncology Unit, Department of Clinical Therapeutics, University of Athens School of Medicine, “Alexandra” Hospital, Athens, Greece |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/21982720$$D View this record in MEDLINE/PubMed |
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| Keywords | Platinum compounds Toxicity Nitrate-mediated dilatation Flow-mediated dilatation Vinca alkaloids Taxanes Vascular endothelial growth factor Antimetabolites Cytotoxics Endothelium |
| Language | English |
| License | https://www.elsevier.com/tdm/userlicense/1.0 Copyright © 2011 Elsevier Ltd. All rights reserved. |
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| Snippet | In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new... Abstract In cancer biology angiogenesis plays a vital role in tumour growth and its subsequent metastatic potential. By targeting the angiogenic process, a new... |
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| SubjectTerms | Angiogenesis Inhibitors - adverse effects Angiogenesis Inhibitors - pharmacology Angiogenesis Inhibitors - therapeutic use Anthracyclines - adverse effects Antimetabolites Antimetabolites - adverse effects Antimetabolites - pharmacology Antineoplastic Agents - adverse effects Antineoplastic Agents - pharmacology Antineoplastic Agents - therapeutic use Bleomycin - adverse effects Cyclophosphamide - adverse effects Cytotoxics Endothelium Endothelium, Vascular - drug effects Flow-mediated dilatation Hematology, Oncology and Palliative Medicine Humans Methotrexate - adverse effects Nitrate-mediated dilatation Platinum compounds Platinum Compounds - adverse effects Platinum Compounds - pharmacology Taxanes Taxoids - pharmacology Taxoids - therapeutic use Toxicity Vascular endothelial growth factor Vinca alkaloids Vinca Alkaloids - pharmacology |
| Title | Endothelial vascular toxicity from chemotherapeutic agents: Preclinical evidence and clinical implications |
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