TABLE 6.

Cardiovascular Adverse Effects From Cancer Therapies

ANTICANCER AGENT	CANCER USE	IMPORTANT COMMON CV ADVERSE EFFECT
Anthracyclines
Doxorubicin	Breast, sarcoma, lung, bladder, gastric, prostate, leukemia, lymphoma, others	Heart failure, cardiomyopathy, arrhythmia
Daunorubicin
Epirubicin
Idarubicin
Mitoxantrone
Alkylating agents
Cisplatin	Lung, bladder, testicular, breast, esophageal, head and neck	Venous and arterial thromboembolism, hypertension
Melphalan	Multiple myeloma, ovarian, neuroblastoma	Arrhythmia
Antimetabolites
Capecitabine	Breast, colon, gastric, pancreatic	Arterial (coronary) vasospasm, (myocardial) ischemia, Takotsubo
Fluorouracil
Monoclonal antibodies
Bevacizumab	Colorectal, cervical, glioblastoma, ovarian, renal, endometrial, sarcoma, breast	Hypertension, arterial and venous thromboembolism, bleeding
Rituximab	Lymphoma, leukemia	Hypotension (infusion reaction)
Ofatumumab		Hypertension
Alemtuzumab
Pertuzumab	Breast, gastric, esophageal	Heart failure, cardiomyopathy
Trastuzumab
Small-molecule tyrosine kinase inhibitors
Axitinib	Renal	Hypertension
Cabozantinib	Thyroid, renal	Hypertension, arterial and venous thromboembolism
Cetuximab	Lung, pancreatic, colorectal	Arterial and venous thromboembolism
Crizotinib	Lung	Bradyarrhythmia, QT prolongation
Dabrafenib	Melanoma	QT prolongation
Dasatinib	Leukemia, gastrointestinal stromal tumor	QT prolongation, pleural effusion, pulmonary hypertension
Erlotinib	Lung, pancreatic, colorectal	Arterial and venous thromboembolism
Ibrutinib	Lymphoma	Atrial fibrillation, hypertension, bleeding
Imatinib	Leukemia, gastrointestinal stromal tumor, myelodysplastic syndrome, melanoma, mastocytosis, sarcoma	Edema
Osimertinib	Lung	Atrial fibrillation, heart failure, cardiomyopathy. QT prolongation
Pazopanib	Renal, sarcoma, thyroid	Hypertension, bradyarrhythmia, heart failure, cardiomyopathy
Ponatinib	Leukemia	Heart failure, cardiomyopathy, hypertension, ischemia, arterial and venous thromboembolism
Ramucirumab	Colorectal, gastric, lung	Hypertension
Regorafenib	Colorectal, gastrointestinal stromal tumor	Hypertension
Sorafenib	Hepatocellular, renal, thyroid	Hypertension, heart failure, cardiomyopathy, ischemia
Sunitinib	Renal, thyroid, sarcoma, gastrointestinal stromal tumor, pancreatic neuroendo-crine tumor	Hypertension, heart failure, cardiomyopathy, arterial and venous thromboembolism
Trametinib	Melanoma	Heart failure, cardiomyopathy, bradyarrhythmia, QT prolongation, arterial and venous thromboembolism, hypertension
Vandetanib	Thyroid	Hypertension, QT prolongation
Vemurafenib	Melanoma	Hypertension, QT prolongation
Ziv-aflibercept	Colorectal	Hypertension
Immune checkpoint inhibitors	Melanoma, lung, kidney, bladder, head and neck, lymphoma	Myocarditis, arrhythmia/sudden cardiac death, cardiomyopathy, vasculitis, pericarditis
PD-1 inhibitors Cemiplimab Nivolumab Pembrolizumab
PD-L1 inhibitors Atezolizumab Avelumab Durvalumab
CTLA-4 inhibitor Ipilimumab
Proteasome inhibitors
Bortezomib	Multiple myeloma, mantle cell lymphoma	Hypertension
Carfilzomib	Multiple myeloma	Hypertension, heart failure, cardiomyopathy, arterial and venous thromboembolism, acute coronary syndrome
mTOR inhibitors
Everolimus	Breast, pancreas	Hypertension
Temsirolimus	Renal	Hypertension
Immunomodulatory drugs	Multiple myeloma	Venous thromboembolism
Lenalidomide
Pomalidomide
Thalidomide
Histone deacetylase inhibitors	Lymphoma	QT prolongation
Belinostat
Vorinostat
Endocrine therapy
Selective estrogen receptor modulators Tamoxifen Toremifene	Breast	Venous thromboembolism, QT prolongation
Aromatase inhibitors Anastrozole Letrozole Exemestane	Breast	Venous thromboembolism, hypertension, hyperlipidemia
Antiandrogens Flutamide Bicalutamide Nilutamide	Prostate	Hypertension, hyperlipidemia, atherosclerosis
CYP17 inhibitor Abiraterone	Prostate	Hypertension, myocardial infarction
Chimeric antigen receptor T-cell therapy	B-cell acute lymphoblastic leukemia (refractory or relapse), large B-cell lymphoma (refractory or relapse)	Tachycardia, arrhythmia, hypotension, hypertension, heart failure, cytokine release syndrome
Axicabtagene ciloleucel
Tisagenlecleucel
Miscellaneous
Ribociclib	Breast	QT prolongation
Arsenic trioxide	Leukemia	QT prolongation
Tretinoin	Leukemia	Heart failure, cardiomyopathy