The use of Vascular Endothelial Growth Factor inhibitors (VEGFi) has become prevalent in the field of medicine, given the high incidence of various pathological conditions necessitating VEGF inhibition within the general population. These conditions encompass a range of advanced neoplasms, such as colorectal cancer, non-small cell lung cancer, renal cancer, ovarian cancer, and others, along with ocular diseases. The utilization of VEGFi is not without potential risks and adverse effects, requiring healthcare providers to be well-prepared for identification and management. VEGFi can be broadly categorized into two groups: antibodies or chimeric proteins that specifically target VEGF (bevacizumab, ramucirumab, aflibercept, ranibizumab, and brolucizumab) and non-selective and selective small molecules (sunitinib, sorafenib, cabozantinib, lenvatinib, regorafenib, etc.) designed to impede intracellular signaling of the VEGF receptor (RTKi, receptor tyrosine kinase inhibitors). The presentation and mechanisms of adverse effects resulting from VEGFi depend primarily on this distinction and the route of drug administration (systemic or intra-vitreal). This review provides a thorough examination of the causes, recognition, management, and preventive strategies for VEGFi toxicities with the goal of offering support to oncologists in both clinical practice and the design of clinical trials.
鉴于普通人群中多种需要抑制血管内皮生长因子（VEGF）的病理状况高发，血管内皮生长因子抑制剂（VEGFi）在医学领域的应用日益广泛。这些病症包括结直肠癌、非小细胞肺癌、肾癌、卵巢癌等多种晚期肿瘤，以及眼部疾病。VEGFi的使用并非没有潜在风险和不良反应，要求医疗从业者做好识别和管理的充分准备。VEGFi大致可分为两类：特异性靶向VEGF的抗体或嵌合蛋白（贝伐珠单抗、雷莫芦单抗、阿柏西普、雷珠单抗、布罗鲁珠单抗），以及旨在阻断VEGF受体细胞内信号传导的非选择性和选择性小分子（舒尼替尼、索拉非尼、卡博替尼、乐伐替尼、瑞戈非尼等，即受体酪氨酸激酶抑制剂）。VEGFi所致不良反应的表现形式和机制主要取决于这一分类差异及给药途径（全身或玻璃体内注射）。本综述系统探讨了VEGFi毒性的成因、识别、处理及预防策略，旨在为肿瘤学家在临床实践和临床试验设计方面提供支持。
肿瘤(癌症)患者之家