Cardiac side effects of molecular targeted therapies: Towards a better dialogue between oncologists and cardiologists

Molecular targeted therapies (MTTs) have become a major component of modern management of various hematological and solid malignancies. However, some MTTs have been associated with cardiotoxicity. MTT-induced cardiovascular side effects include left ventricular systolic dysfunction, heart failure, conduction abnormalities, acute coronary syndrome, and hypertension. One of the most threatening complications of MTT, and notably of angiogenic inhibitors, is QT prolongation with the risk of torsades de pointe and sudden death. The precise incidence of cardiovascular events associated with MTT as well as their reversibility are unknown. Here, we summarize what is known about the cardiotoxicity of MTT, emphasizing MTTs that target tyrosine kinases. We have tried to provide both the basic mechanisms underlying specific cardiotoxicities (such as the interruption of specific signaling pathways leading to cardiomyocyte dysfunction and/or death), and offer guidance regarding the optimal way to detect and treat these cardiotoxicities.