Cardiovascular safety profile of taxanes and vinca alkaloids: 30 years FDA registry experience.
Adolescent
Adult
Adverse Drug Reaction Reporting Systems
/ statistics & numerical data
Aged
Aged, 80 and over
Cardiotoxicity
Cardiovascular Diseases
/ chemically induced
Female
Humans
Incidence
Male
Middle Aged
Neoplasms
/ drug therapy
Registries
Taxoids
/ adverse effects
United States
/ epidemiology
United States Food and Drug Administration
/ statistics & numerical data
Vinca Alkaloids
/ adverse effects
Young Adult
drug monitoring
epidemiology
healthcare
outcome assessment
Journal
Open heart
ISSN: 2053-3624
Titre abrégé: Open Heart
Pays: England
ID NLM: 101631219
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
07
09
2021
accepted:
29
11
2021
entrez:
25
12
2021
pubmed:
26
12
2021
medline:
3
2
2022
Statut:
ppublish
Résumé
Antimicrotubular agents are among the most commonly used classes of chemotherapeutic agents, but the risk of cardiovascular adverse events (CVAEs) remains unclear. Our objective was to study the CVAEs associated with antimicrotubular agents. The Food and Drug Administration's Adverse Event Reporting System was used to study CVAEs in adults from 1990 to 2020. Reported single-agent (only taxane or vinca alkaloid) CVAEs were compared with combination therapy (with at least one of the four major cardiotoxic drugs: anthracycline, HER2Neu inhibitors, tyrosine kinase inhibitors and checkpoint inhibitors) using adjusted polytomous logistic regression. Over 30 years, 134 398 adverse events were reported, of which 18 426 (13.4%) were CVAEs, with 74.1% due to taxanes and 25.9% due to vinca alkaloids. In 30 years, there has been a reduction in the proportion of reported CVAEs for taxanes from 15% to 11.8% (Cochran-Armitage P-trends <0.001) with no significant change in the proportion of reported CVAEs for vinca alkaloids (9.2%-11.7%; P-trends=0.06). The proportion of reported CVAEs was lower in both taxane and vinca alkaloid monotherapy versus combination therapy (reporting OR=0.50 and 0.55, respectively). Anthracyclines and HER2Neu inhibitor combinations with taxanes or vinca alkaloids primarily drove the higher burden of combination CVAEs. Hypertension requiring hospitalisation and heart failure was significantly lower in monotherapy versus combination antimicrotubular agent therapy. Antimicrotubular agents are associated with CVAEs, especially in combination chemotherapy regimens. Based on this study, we suggest routine cardiovascular assessment of patients with cancer before initiating antimicrotubular agents in combination therapy.
Identifiants
pubmed: 34952868
pii: openhrt-2021-001849
doi: 10.1136/openhrt-2021-001849
pmc: PMC8710909
pii:
doi:
Substances chimiques
Taxoids
0
Vinca Alkaloids
0
Types de publication
Journal Article
Multicenter Study
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : NCATS NIH HHS
ID : UL1 TR001863
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL142097
Pays : United States
Organisme : NIAMS NIH HHS
ID : R01 AR070029
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL134354
Pays : United States
Organisme : NCI NIH HHS
ID : K12 CA133250
Pays : United States
Organisme : NCI NIH HHS
ID : P30 CA016058
Pays : United States
Organisme : NIA NIH HHS
ID : R56 AG064895
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL126949
Pays : United States
Organisme : NHLBI NIH HHS
ID : K23 HL155890
Pays : United States
Informations de copyright
© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Déclaration de conflit d'intérêts
Competing interests: None declared.
Références
N Engl J Med. 2007 Oct 25;357(17):1695-704
pubmed: 17960012
Pharmacol Ther. 1991 Oct;52(1):35-84
pubmed: 1687171
Eur Heart J. 2019 Jun 7;40(22):1756-1763
pubmed: 30085070
J Natl Cancer Inst Monogr. 1993;(15):117-30
pubmed: 7912518
J Clin Oncol. 1991 Sep;9(9):1704-12
pubmed: 1678781
Anal Cell Pathol (Amst). 2015;2015:690916
pubmed: 26484003
J Urol. 2021 Sep;206(3):613-622
pubmed: 33872049
Nat Rev Cardiol. 2020 Aug;17(8):503-522
pubmed: 32218531
JACC CardioOncol. 2019 Dec 17;1(2):172-178
pubmed: 34396179
Bull World Health Organ. 2007 Nov;85(11):867-72
pubmed: 18038077
Clin Cancer Res. 2001 Jun;7(6):1511-5
pubmed: 11410484
Cardiooncology. 2019 Aug 22;5:14
pubmed: 32154020
Eur J Cancer. 1978 May;14(5):501-5
pubmed: 348479
Aging (Albany NY). 2019 Sep 27;11(18):7948-7960
pubmed: 31562288
Nat Rev Cardiol. 2020 Aug;17(8):474-502
pubmed: 32231332
Cancer Med. 2021 Jun;10(12):3862-3872
pubmed: 33982883
Curr Oncol Rep. 2021 Aug 27;23(11):128
pubmed: 34453232
Ann Oncol. 1996 Sep;7(7):687-93
pubmed: 8905026
Prog Cardiovasc Dis. 2010 Sep-Oct;53(2):94-104
pubmed: 20728696
Am J Hematol. 2015 Apr;90(4):E66-72
pubmed: 25580915
ESMO Open. 2021 Oct;6(5):100252
pubmed: 34461483