Association between tyrosine‐kinase inhibitor induced hypertension and treatment outcomes in metastatic renal cancer

Gadd, Monique; Pranavan, Ganesalingam; Malik, Laeeq

doi:10.1002/cnr2.1275

Cited by 6 publications

(1 citation statement)

References 14 publications

(33 reference statements)

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“…The molecular pathways involved in TKI-induced hypertension still need to be elucidated, and a genetic predisposition may be involved [57]. Nevertheless, the development of hypertension seems to be correlated with better TKI efficacy [60]. Specific attention should also be paid to patients at risk of hemorrhages as the TKI in association with anticoagulant therapy has been reported to increase the bleeding risk [61].…”

Section: Combination Therapy Versus Tki Alone In Selected Patient Subgroupsmentioning

confidence: 99%

Combination Therapy in Renal Cell Carcinoma: the Best Choice for Every Patient?

et al. 2021

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Purpose of Review Therapeutic alternatives to treat metastatic renal cell carcinoma (mRCC) are increasing, and combination therapies, including antiangiogenic agents and tyrosine kinase/mTOR/immune checkpoint inhibitors, are identified as the gold standard driven by the results of recent clinical studies. Nevertheless, the real-world RCC population is very heterogeneous, with categories of patients not represented in the enrolled trial population who may not benefit more from these treatments. The purpose of this expert review is to assess the rationale on which tyrosine kinase alone may still be a viable first-line treatment option for some subgroups of patients with mRCC. Recent Findings The first-line treatment with tyrosine kinase inhibitor monotherapy can still be considered an effective tool for addressing selected mRCCs, as highlighted by the successful outcome in a range of subjects such as favorable-risk patients, the ones suffering from autoimmune diseases, those with pancreatic or lung metastases, or previously undergoing organ transplantation and elderly subjects. Summary Some selected categories of patients may still benefit from monotherapy with TKI, and smart sequential therapies can also be considered instead of a combination strategy. Tyrosine kinase inhibitors can also act as immune modulator agents, boosting the immune response to facilitate and potentiate the therapeutic effectiveness of subsequent immunotherapy.

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Section: Combination Therapy Versus Tki Alone In Selected Patient Subgroupsmentioning

confidence: 99%

Combination Therapy in Renal Cell Carcinoma: the Best Choice for Every Patient?

et al. 2021

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Looking into the toxicity potential and clinical benefits of tyrosine kinase inhibitors (TKIs)

Ajideh

Kamyab

Yazdi

2024

Encyclopedia of Toxicology

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A Phase II study of neoadjuvant axitinib for reducing the extent of venous tumour thrombus in clear cell renal cell cancer with venous invasion (NAXIVA)

et al. 2022

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Background Surgery for renal cell carcinoma (RCC) with venous tumour thrombus (VTT) extension into the renal vein (RV) and/or inferior vena cava (IVC) has high peri-surgical morbidity/mortality. NAXIVA assessed the response of VTT to axitinib, a potent tyrosine kinase inhibitor. Methods NAXIVA was a single-arm, multi-centre, Phase 2 study. In total, 20 patients with resectable clear cell RCC and VTT received upto 8 weeks of pre-surgical axitinib. The primary endpoint was percentage of evaluable patients with VTT improvement by Mayo level on MRI. Secondary endpoints were percentage change in surgical approach and VTT length, response rate (RECISTv1.1) and surgical morbidity. Results In all, 35% (7/20) patients with VTT had a reduction in Mayo level with axitinib: 37.5% (6/16) with IVC VTT and 25% (1/4) with RV-only VTT. No patients had an increase in Mayo level. In total, 75% (15/20) of patients had a reduction in VTT length. Overall, 41.2% (7/17) of patients who underwent surgery had less invasive surgery than originally planned. Non-responders exhibited lower baseline microvessel density (CD31), higher Ki67 and exhausted or regulatory T-cell phenotype. Conclusions NAXIVA provides the first Level II evidence that axitinib downstages VTT in a significant proportion of patients leading to reduction in the extent of surgery. Clinical trial registration NCT03494816.

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Association between tyrosine‐kinase inhibitor induced hypertension and treatment outcomes in metastatic renal cancer

Cited by 6 publications

References 14 publications

Combination Therapy in Renal Cell Carcinoma: the Best Choice for Every Patient?

Combination Therapy in Renal Cell Carcinoma: the Best Choice for Every Patient?

Looking into the toxicity potential and clinical benefits of tyrosine kinase inhibitors (TKIs)

A Phase II study of neoadjuvant axitinib for reducing the extent of venous tumour thrombus in clear cell renal cell cancer with venous invasion (NAXIVA)

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