Table 1 |.
Spectrum of vascular toxic effects of conventional chemotherapies
| Therapy | Cancer therapy indications (label and off-label) | Toxicity | |||||||
|---|---|---|---|---|---|---|---|---|---|
| HTN | Angina | AMI | Raynaud syndrome | Stroke | PAD | Pulmonary HTN | DVT or PE | ||
| Alkylating agents | |||||||||
| Cisplatin | Bladder cancer, breast cancer, cervical cancer, endometrial carcinoma, head and neck cancer, HL, malignant pleural mesothelioma, multiple myeloma, NHL, oesophageal and gastric cancer, osteosarcoma, ovarian cancer, penile cancer, SCLC, testicular cancer | – | ++ | ++ | + | + | + | – | – |
| Cyclophosphamide | ALL, breast cancer, CLL, Ewing sarcoma, HL, multiple myeloma, NHL, SCLC, stem cell transplant condition | – | + | + | – | – | – | + | – |
| Antimetabolites | |||||||||
| 5-Fluorouracil | Anal carcinoma, bladder cancer, breast cancer, cervical cancer, colorectal cancer, gastric cancer, hepatobiliary cancer, oesophageal cancer, pancreatic cancer, squamous cell carcinomas | – | ND | ND | ND | ND | – | – | – |
| Capecitabine | Anal carcinoma, breast cancer, colorectal cancer, fallopian cancer, gastric cancer, hepatobiliary cancer, oesophageal cancer, ovarian cancer, pancreatic cancer, peritoneal cancer, carcinoma of unknown primary | + | ++ | ++ | + | + | – | – | + |
| Gemcitabine | Adenocarcinoma of unknown primary, bladder cancer, breast cancer, cervical cancer, head and neck cancer, hepatobiliary cancer, HL, malignant pleural mesothelioma, NHL, NSCLC, ovarian cancer, pancreatic cancer, sarcomas, SCLC, testicular cancer, uterine cancer | – | + | + | + | – | – | – | – |
| Microtubule-binding agents | |||||||||
| Paclitaxel | Adenocarcinoma of unknown primary, bladder cancer, breast cancer, cervical cancer, head and neck cancers, Kaposi sarcoma, NSCLC, oesophageal and gastric cancer, ovarian cancer, penile cancer, SCLC, soft tissue sarcoma, testicular germ cell tumours, thymoma | + | + | + | – | – | – | – | + |
| Antitumour antibiotics | |||||||||
| Bleomycin | HL, ovarian germ cell cancer, testicular cancer | – | + | + | + | + | – | + | – |
| Vinca alkaloids | |||||||||
| Vincristine | ALL, central nervous system tumours, HL, Ewing sarcoma, gestational trophoblastic tumours, multiple myeloma, NHL, ovarian cancer, primary CNS lymphoma, SCLC, thymoma | ND | ND | ND | ND | – | – | – | – |
| Immunomodulatory drugs | |||||||||
| IFNα2B | Hairy cell leukaemia, Kaposi sarcoma, lymphoma, malignant melanoma | ++ | +++ | ++ | ++ | ++ | ++ | ++ | ++ |
| Lenalidomide | CLL, diffuse large B cell lymphoma, mantle cell lymphoma, multiple myeloma, myelodysplastic syndrome | ++ | ++ | ++ | – | ++ | – | – | +++ |
| Thalidomide | Multiple myeloma, systemic light chain amyloidosis, Waldenström macroglobulinaemia | – | – | – | – | – | – | – | +++ |
Based on data from Micromedex (IBM, NY, USA) and Lexicomp (Wolters Kluwer, Netherlands). –, not reported; +, uncommon (<1%), ++, common (1–10%), +++, very common (>10%). ALL, acute lymphoblastic leukaemia; AMI, acute myocardial infarction; CLL, chronic lymphocytic leukaemia; CNS, central nervous system; DVT, deep-vein thrombosis; HL, Hodgkin lymphoma; HTN, hypertension; ND, frequency not defined; NHL, non-Hodgkin lymphoma; NSCLC, non-small-cell lung cancer; PAD, peripheral artery disease; PE, pulmonary embolism; SCLC, small-cell lung cancer.