Myocardial ischemia secondary to VEGF-TKIs, ranging from asymptomatic forms to acute coronary syndromes, has a low incidence: 1.4% for sunitinib, 1.7% for sorafenib and less than 1% for bevacizumab in breast cancer patients, but increased to 3.8% in metastatic disease [4,5]. The gene discussed is VEGFA; the disease is acute coronary syndrome.