HUNG-JU LINSHANG-GIN WULo, YinYinLoFeng, Po-HaoPo-HaoFengKUAN-YU CHENYEN-WEN WU2026-03-102026-03-102026-02https://scholars.lib.ntu.edu.tw/handle/123456789/736145Introduction Kinase inhibitors (KIs) play an important role in targeted therapy for lung cancer. Lorlatinib as a third-generation anaplastic lymphoma kinase (ALK) inhibitor, provided unprecedentedly prolonged survival for patients with advanced non-small cell lung cancer harboring ALK rearrangements. However, this benefit comes at a cost of hyperlipidemia with possible implications for cardiovascular disease (CVD) in long-term survivors. This review aims to provide multidisciplinary evidence-based recommendations for managing hyperlipidemia related to KIs. Methods We established a collaborative study group comprising cardiologists, thoracic oncologists, and a pharmacist. The working group conducted a comprehensive literature search to identify KIs investigated or approved for lung cancer treatment and associated with hyperlipidemia. In addition, the most recent clinical trials and atherosclerotic CVD guidelines for the general and cancer patient populations were also reviewed. Results Among KIs, ALK inhibitors, mammalian target of rapamycin inhibitors, Janus kinase inhibitors, and multikinase inhibitors demonstrated clinical benefits for patients with lung cancer but are also associated with hyperlipidemia. Optimal target levels for total cholesterol, low-density lipoprotein cholesterol, and triglycerides in managing KI-associated hyperlipidemia for the primary and secondary prevention of CVD were recommended. Furthermore, we proposed strategies that include baseline risk assessment, regular blood lipid monitoring, and timely pharmacological interventions. Dose adjustments and discontinuation, evaluation for drug-drug interactions, patient education, and lifestyle modifications were also detailed. Conclusions A multifaceted approach is proposed for lung cancer patients receiving KI therapy to manage hyperlipidemia, minimize CVD risks, optimize treatment outcomes, and improve quality of life.enCardiovascular diseaseHyperlipidemiaKinase inhibitorLow-density lipoprotein cholesterolLung cancerreview article10.1016/j.ctrv.2025.10306541564805