How do VSPI anti-cancer drugs cause high blood pressure and heart damage?

Markers and mediators of angiogenesis inhibitor-induced vascular and myocardial toxicity:  A prospective study in patients with cancer

Tumours can be prevented from growing new blood vessels by a type of drug called vascular endothelial growth factor-signalling pathway inhibitors (VSPIs). VSPIs have potent anti-cancer effects but they also can cause high blood pressure and may damage the heart. People who are treated with VSPIs are at risk of heart failure, heart attack, stroke, and kidney failure. Sometimes the dose must be reduced or treatment stopped altogether, meaning that some people with cancer do not get the full benefits of VSPI therapy. How VSPIs cause these damaging side effects is poorly understood. However, changes in the blood vessels in the heart and the rest of the body appear to be an important factor. Dr Ninian Lang at the University of Glasgow will lead a team of scientists and physicians with a broad range of expertise to investigate the effects of VSPIs by observing the heart and blood vessels in 100 people with cancer before and during VSPI treatment. Using detailed heart and blood vessel scans, blood pressure monitoring, and blood and urine tests, the researchers aim to find out what blood vessel abnormalities VSPIs cause and how these contribute to the onset of high blood pressure and heart damage. This research could help us predict which people with cancer are most susceptible to high blood pressure and heart damage induced by VSPI therapy, and inform us of the best ways to treat and prevent these side effects.