Cardiovascular effects of targeted molecular therapies and vascular toxicity of chemotherapy.

Targeted molecular therapy is the newest and most dynamic chapter of current oncology research, boosted by the recent complete decoding of the human genome. The most commonly used classes of molecular drugs currently include: small molecule tyrosine kinase inhibitors (TKI) and multikinase inhibitors, monoclonal antibody blocking transduction signals, angiogenesis inhibitors, proteasome inhibitors, histone deacetylase inhibitors and demethylation agents, epigenetic therapy, differentiation agents, gene therapy strategies and vaccines. Although targeted therapies are considered to be less toxic and better tolerated by patients compared to classical chemotherapeutic agents, rare but severe complications have been described, and longer follow-up is required to determine the exact profile and prognosis of associated cardiac adverse reactions. Both conventional chemotherapy and targeted molecular therapies are associated with well-defined short-term and long-term risks of cardiovascular events. Because these agents are commonly used for curative purposes, benefits maximization and concomitant reduction of cardiac risk have become a priority in oncology management, as well as monitoring to identify late toxicity. [ABSTRACT FROM AUTHOR]