Angiogenesis inhibition‐induced hypertension and renal injury: prevention by aspirin?

Angiogenesis, the formation of new blood vessels from the existing vasculature, is essential for tumor growth and metastasis. In the last decade, angiogenesis inhibitors directed at the vascular endothelial growth factor (VEGF) pathway have become a first line treatment for several malignancies, including some previously untreatable cancers. However, VEGF inhibitors (VEGFi) can induce severe cardiovascular, most frequently hypertension, and renal (proteinuria, glomerular endotheliosis) toxicities. As such, patients treated with VEGFi may have improved cancer outcomes, but at the cost of an increased risk of cardiovascular disease. Furthermore, dose intensity and prolonged use of VEGFi may be limited by cardiovascular side effects, requiring dose reduction and/or early termination of treatment which compromises VEGFi efficacy and patient survival. Novel strategies to prevent these unwanted side effects during angiogenesis inhibition are urgently needed to improve quality of life and survival in cancer patients. In this project we will test the hypothesis that aspirin confers protection during VEGFi therapy with benefits for both the control of arterial pressure and renal function.