Another ‘Smart’ Cancer Drug Can Have Toxic Effects on the Heart

(Ivanhoe Newswire) -- Sunitinib, one of the new cancer ‘smart’ drugs is showing a risk for heart failure, heart attack, and hypertension in patients with a cancer called gastrointestinal stromal tumor (GIST).

The so-called ‘smart drugs’ are tyrosine kinase inhibitors that target specific signaling molecules inside cancer cells that aid in its spread. A study on another targeted ‘smart’ therapy, imitinib, was reported last year in Nature Medicine, to be associated with heart failure in patients with chronic myelogenous leukemia.

Researchers at Children’s Hospital in Boston, Dana-Farber Cancer Institute        (Boston) and Thomas Jefferson University(Philadelphia), in a collaborative study, examined cardiac toxicity and sunitinib. This new ‘retrospective analysis’ was lead by Ming Hui Chen, M.D., MMS, a cardiologist at Children’s.

In a phase I/II trial at Dana-Farber, 75 patients with imatinib-resistant GIST, who were on multiple cycles of sunitinib were studied. 6 of them (8%) developed symptoms consistent with moderate to severe congestive heart failure and 2 had heart attacks. In all, 8 patients (11%) had some kind of cardio vascular event while taking FDA approved or lower doses of sunitinib. Patients with preexisting coronary artery disease were more likely to develop problems. 19% of the 36 people who were taking the FDA approved dose showed decreases in the left ventricle’s ability to pump blood. 47% developed hypertension. And though hypertension is a common side effect of cancer drugs, the number of patients affected and degree of increase in systolic blood pressure of those taking sunitinib was notable, said Chen.

The sunitinib study highlights potential concerns about multi targeted cancer drugs especially in children. These kinds of side effects are especially important to manage in order for children to survive the cancer in good health well into adulthood.

“Early identification of cardiac side effects is an important part of keeping patients on life saving cancer therapy over the long term,” says Chen.

For the patients in this study, the cardiac dysfunction and hypertension were usually medically manageable. Above all, they were most often able to resume sunitinib therapy after the addition of cardiac medications and/or dose adjustments.

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 SOURCE: The Lancet Dec. 15, 1007