Hypertension as predictor of sunitinib treatment outcome in metastatic renal cell carcinoma

Bono, Petri; Rautiola, Juhana; Utriainen, Tapio; Joensuu, Heikki

doi:10.3109/0284186x.2010.543696

Cited by 69 publications

(58 citation statements)

References 12 publications

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“…Rini et al [10] were the first to describe sunitinib-induced hypertension as a strong positive predictive value for PFS and OS in mRCC patients. Recently, Bono et al [17] found similar results in a retrospective trial of 64 consecutive mRCC patients treated with sunitinib. In this trial, 38% of patients developed hypertension during treatment with sunitinib and were found to have significant increases in overall response rate, PFS and OS in comparison to patients who did not develop hypertension.…”

Section: Discussionsupporting

confidence: 63%

Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines

Szmit

Langiewicz

Żłnierek

et al. 2011

Kidney Blood Press Res

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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.

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Section: Discussionsupporting

confidence: 63%

Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines

Szmit

Langiewicz

Żłnierek

et al. 2011

Kidney Blood Press Res

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“…In study with sunitinib, Rini et al [5] demonstrated that patients with hypertension defined by maximum systolic BP ≥140 mm Hg had significantly longer survival parameters of both PFS and overall survival. Bono et al [4] showed that persistent BP >150/100 mm Hg or BP requiring intensification of preexisting antihypertensive medication are the positive predictive factors in patients treated with sunitinib.…”

Section: Discussionmentioning

confidence: 99%

“…In the case of sunitinib, this effect has already been thoroughly analyzed [3,4,5,6], and it has been shown that a significant risk of the development of heart failure exists during treatment with sunitinib. This risk may be associated with iatrogenic hypertension [7].…”

Section: Introductionmentioning

confidence: 99%

Cardiovascular Comorbidities for Prediction of Progression-Free Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Sorafenib

Szmit

Zaborowska

Waśko-Grabowska

et al. 2012

Kidney Blood Press Res

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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.

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“…Patients with hypertension continued to survive longer than patients without hypertension, independent of use of antihypertensive agents, sunitinib dose reductions, or both. Several other studies have supported this notion [6][7][8][9]. However, the definition of hypertension and methodology may impact results [10].…”

mentioning

confidence: 94%

“…Treatment-induced adverse events and their impact on outcome were assessed in patients with mRCC treated with sunitinib at various starting doses [12]. A milder definition for thrombocytopenia (<LLN) was used whereas definitions for hypertension and neutropenia were unchanged from previous studies [7,11]. The development during therapy of hypertension, neutropenia, and thrombocytopenia was associated significantly with longer PFS and OS.…”

mentioning

confidence: 99%

On-treatment biomarkers in metastatic renal cell carcinoma: towards individualization of prognosis?

Donskov

Heng

Rini

2016

Expert Review of Anticancer Therapy

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Hypertension as predictor of sunitinib treatment outcome in metastatic renal cell carcinoma

Abstract: Sunitinib-associated hypertension may be a strong predictive marker for treatment efficacy in metastatic RCC.

Cited by 69 publications

References 12 publications

Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines

Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines

Cardiovascular Comorbidities for Prediction of Progression-Free Survival in Patients with Metastatic Renal Cell Carcinoma Treated with Sorafenib

On-treatment biomarkers in metastatic renal cell carcinoma: towards individualization of prognosis?

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