Cardiovascular toxicity of anaplastic lymphoma kinase inhibitors for patients with non-small cell lung cancer: a network meta-analysis

<b>Aim:</b> We conducted network meta-analysis to assess cardiovascular toxicity of anaplastic lymphoma kinase-tyrosine kinase inhibitors (<i>ALK</i>-TKIs).<b>Materials & methods:</b> Eleven articles involving 2855 patients and six interventions including crizotinib, alectinib, ceritinib, lorlatinib, brigatinib and chemotherapy were analyzed.<b>Results:</b> No significant difference was observed in overall cardiovascular risk among <i>ALK</i>-TKIs. Subgroup analysis showed that for cardiac toxicity, crizotinib and alectinib were more likely to cause myocardial rhythm abnormalities. Crizotinib and ceritinib had a higher risk of Q-T prolongation than chemotherapy. For vascular toxicity, crizotinib and ceritinib had a higher risk of thrombotic events than brigatinib. Crizotinib and lorlatinib were more likely to cause blood pressure abnormalities.<b>Conclusion:</b> Clinicians should carefully monitoring cardiovascular events when <i>ALK</i>-TKIs used in NSCLCs patients with baseline cardiovascular diseases.