Table 1.
Cardiovascular adverse effects of NSCLC and SCLC treatments.
| Treatment Class | Examplar Drugs | Cardiac Adverse Effects |
|---|---|---|
| Immune checkpoint inhibitors | Pembrolizumab, Nivolumab, Atezolizumab, Durvalumab | myocarditis, pericarditis, vasculitis, conduction delay, complete heart block, atrial fibrillation, HF, MI, elevated troponin, elevated BNP, arrhythmias |
| Targeted therapies | ||
| EGFR inhibitors | Erlotinib, Gefitinib, Osimertinib* | QT prolongation, HF, SVT |
| BRAF inhibitor | Dabrafenib | HF |
| MEK inhibitor | Trametinib | HF |
| ALK inhibitor | Brigatinib, Crizotinib, Certinib, Alectinib | conduction disease** |
| VEGF inhibitor | Bevacizumab | arterial HTN, HF, atrial fibrillation, arterial thromboembolic events, Takotsubo cardiomyopathy |
| Cytotoxic agents | ||
| Platinum | Cisplatin a | thromboembolic events, elevated cardiac enzymes, MI, HF, LV hypertrophy, atrial fibrillation |
| Anti-nucleoside | Gemcitabine a | thromboembolic events |
| Vinca alkaloids a | ST elevation, MI | |
| Anti-folate | Pemetrexed a | MI, thromboembolism |
| Taxanes | Paclitaxel, Docetaxel | bradycardia, asymptomatic left bundle branch block, ventricular tachycardia, AV conduction delay |
| Anthracycline | Doxorubicin | cardiomyopathy, HF |
*Out of the EGFR inhibitors, osimertinib had the most significant association with the listed adverse effects
**Conduction disease defined by Waliany et al.17 as bradycardia, sinus node dysfunction, AV node block, bundle branch block
a
The cardiac effects of cisplatin, vinca alkaloids, and pemetrexed were often observed in conjunction with the use of another therapy modality