A Rapid Review of Supportive Care Management of Treatment-Related Acute and Long-Term Cardiac Toxicities in Children with Cancer and Childhood Cancer Survivors Who Have Received Tyrosine Kinase Inhibitors (TKIs)

Abstract

Background

Advances in targeted cancer therapies have transformed the management of pediatric malignancies. Tyrosine kinase inhibitors (TKIs), a specific class of targeted agents, inhibit signaling pathways essential to cancer cell survival. TKIs have improved outcomes in specific pediatric cancers. However, TKIs are associated with acute and long-term cardiotoxicities. Supportive care management aimed at prevention, early detection, and timely intervention is necessary to mitigate cardiotoxicity associated with TKIs.

Method

This rapid review examined the supportive care management used in children with cancer and childhood cancer survivors who received TKIs as part of their treatment. TKIs were selected due to their frequent use in pediatric oncology. Eligible studies, published between 2019 and 2025, included patients aged 0–21 years. From 206 citations, 30 duplicates were removed, and 176 records were screened in Rayyan. Fifteen full texts were reviewed, and two additional studies were hand-searched, yielding eight studies for inclusion. Data extraction, synthesis, and PRISMA documentation were completed collaboratively by the review team.

Results

Five key categories in supportive care management emerged: surveillance strategies, preventive strategies, cardiac medication use, collaboration between pediatric oncology and cardiology, and transition of care for childhood cancer survivors.

Conclusion

TKIs are associated with significant cardiotoxic risk in pediatric oncology. This review identified five supportive care categories that may inform future interdisciplinary research and guide the development of evidence-based supportive care recommendations aimed at optimizing cardiovascular outcomes in this patient population.