{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:54:23Z","timestamp":1784310863601,"version":"3.55.0"},"reference-count":37,"publisher":"Wiley","issue":"13","license":[{"start":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T00:00:00Z","timestamp":1750464000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acsjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Multitargeted tyrosine kinase inhibitors (MTKIs) have increasingly been used for the treatment of pediatric and young adult patients with solid tumors. Whereas cardiac toxicity is documented in adults, data remain limited in pediatrics. This study sought to characterize the incidence and outcomes of acute cardiotoxicity in pediatric patients with solid tumors treated with an MTKI.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective review was conducted of patients who received MTKIs from 2000 to 2021 at St. Jude Children\u2019s Research Hospital. Analyses included patient and disease characteristics, treatment specifics, and measurements of cardiotoxicity (ejection fraction [EF], &lt;55%; global longitudinal strain [GLS], \u221217 to 0; <jats:italic>z<\/jats:italic> scores, &gt;2 for left atrial end\u2010systolic volume index, left ventricular end\u2010diastolic diameter, and left ventricular end\u2010systolic diameter). Hypertension (HTN) was evaluated independently, and defined with American Academy of Pediatrics clinical practice guidelines and American College of Cardiology\/American Heart Association HTN guidelines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 112 patients, 73 (65%) underwent echocardiography during MTKI therapy. Of 56 patients without prior cardiotoxicity, 17 (32.1%) developed cardiac toxicity during treatment. Of 48 patients without preexisting HTN, 36 (72%) developed HTN at 6 months. Abnormal GLS was the most frequent new\u2010onset cardiac finding (29.5% at 6 months). Of 61 patients with sequential echocardiograms, 51.4% had a \u22655% decline in EF but only 3.6% required MTKI dose reductions as a result of cardiotoxicity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Despite changes in cardiac function while on MTKIs, reductions because of cardiac toxicity were infrequent. Routine monitoring of cardiac function during MTKI use and early intervention may enable patients to continue therapy while safeguarding cardiovascular health.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.35940","type":"journal-article","created":{"date-parts":[[2025,6,21]],"date-time":"2025-06-21T12:53:32Z","timestamp":1750510412000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Acute cardiotoxicity in pediatric and adolescent patients with solid tumors treated with tyrosine kinase inhibitors"],"prefix":"10.1002","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1722-2924","authenticated-orcid":false,"given":"Jessica","family":"Gartrell","sequence":"first","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel A.","family":"Mulrooney","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"},{"name":"Department of Epidemiology and Cancer Control St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chia\u2010Wei","family":"Hsu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haitao","family":"Pan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5807-4876","authenticated-orcid":false,"given":"Sara M.","family":"Federico","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5338-3979","authenticated-orcid":false,"given":"Alberto S.","family":"Pappo","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Helmig","sequence":"additional","affiliation":[{"name":"Department of Oncology St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly J.","family":"Meredith","sequence":"additional","affiliation":[{"name":"Department of Nursing St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia","family":"Pease","sequence":"additional","affiliation":[{"name":"Department of Nursing St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony M.","family":"Christensen","sequence":"additional","affiliation":[{"name":"Department of Pharmacy and Pharmaceutical Sciences St. Jude Children\u2019s Research Hospital  Memphis Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary","family":"Beasley","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Iowa Stead Family Children\u2019s Hospital Carver College of Medicine  Iowa City Iowa USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Bishop","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Arkansas Children\u2019s Hospital  Little Rock Arkansas 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