Background/Aims: This retrospective analysis compared progression-free survival (PFS) in 111 patients who developed or had preexisting hypertension with those who did not during treatment with second-line sunitinib. Secondary objectives included overall survival (OS) and safety. Methods: Patients with metastatic renal cell carcinoma (mRCC) received sunitinib 50 mg orally once daily in 6-week cycles according to a 4-week on/2-week off treatment schedule. Treatment was continued until disease progression, unacceptable toxicity, withdrawal of consent, or death. Resting blood pressure (BP) was monitored by clinic and home measurements. Hypertension was defined as systolic BP ≧140 and/or diastolic BP ≧90 mm Hg. Subsequent antihypertensive treatment was empirical, depending on the patient. Results:Fifty-four (48.6%) patients experienced elevated BP related to sunitinib. Of these, 10 had preexisting hypertension. Patients who developed hypertension related to sunitinib treatment experienced significantly longer PFS and OS compared to those who did not (p < 0.00001). Patients who required at least 3 antihypertensive drugs had the longest PFS (p = 0.00002) and OS (p = 0.00001). Conclusions: The development of hypertension during sunitinib treatment was a positive predictive factor associated with a significantly longer PFS and OS in patients with mRCC.

Further evaluation of the effect of these therapies on bone metastases in RCC is warranted.

Background/Aims: The purpose of the present study was to determine the relationship between iatrogenic arterial hypertension or baseline cardiovascular comorbidities and outcomes in metastatic renal cell cancer (mRCC) patients treated with sorafenib. Methods: The study included 148 mRCC patients treated with sorafenib, 63 patients (43%) had preexisting hypertension, 18 patients (12%) coronary artery disease, and 15 patients (10%) mild heart failure. Resting blood pressure (BP) was monitored by clinic and home measurements. Sorafenib-induced hypertension was defined as systolic BP ≥140 and/or diastolic BP ≥90 mm Hg during the first month of treatment. Results: Preexisting cardiovascular comorbidities were not associated with worsening prognosis of patients with mRCC treated with sorafenib. During the first month of treatment, sorafenib-induced hypertension was diagnosed in 76 patients (51.4%), and these patients had a significantly longer PFS (p < 0.00001) and a significantly lower overall mortality risk (p = 0.038). Patients with preexisting and sorafenib-induced hypertension had the longest PFS (p < 0.00001). Conclusions: Sorafenib-induced hypertension is a positive predictive factor in mRCC patients treated with sorafenib, especially in patients with a history of hypertension.

Pancreatic cancer (PC) is the seventh leading cause of cancer death across the world. Poor prognosis of PC is associated with several factors, such as diagnosis at an advanced stage, early distant metastases, and remarkable resistance to most conventional treatment options. The pathogenesis of PC seems to be significantly more complicated than originally assumed, and findings in other solid tumours cannot be extrapolated to this malignancy. To develop effective treatment schemes prolonging patient survival, a multidirectional approach encompassing different aspects of the cancer is needed. Particular directions have been established; however, further studies bringing them all together and connecting the strengths of each therapy are needed. This review summarises the current literature and provides an overview of new or emerging therapeutic strategies for the more effective management of metastatic PC.

& Cezary Szczylik (2009) Reversible myocardial dysfunction in a young woman with metastatic renal cell carcinoma treated with sunitinib, Acta Oncologica, 48:6, 921-925,

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