Oncology Medical News about cardiovascular toxicity;sunitinib therapy;metastatic renal cell carcinoma

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Cardiovascular toxicity following sunitinib therapy in metastatic renal cell carcinoma: a multicenter analysis
Annals of Oncology, 06/02/09

Di Lorenzo G et al. - In a trial to examine cardiac adverse events in pts with metastatic renal cell carcinoma (RCC) who underwent treatment with sunitinib, it was shown that pts undergoing sunitinib, especially those with a previous history of hypertension and coronary heart disease, are at increased risk for cardiovascular events and should be monitored for exacerbations of their hypertension and for evidence of left ventricular ejection fraction (LVEF) dysfunction during treatment.

Methods

Medical records of 175 pts with metastatic RCC treated with sunitinib at 8 Italian institutions were retrospectively reviewed.
Alterations in LVEF and blood pressure were evaluated.
Pts with preexisting cardiac risk factors were specifically scrutinized for increased expression of cardiac changes.

Results

Grade 3 hypertension was seen in 17 pts (9.7%); in 12 of these 17, hypertension developed after receiving the third sunitinib cycle.
Among these 17 pts, 12 (70.6%) also experienced systolic LVEF dysfunction; in all, 33 of the 175 pts (18.9%) developed some degree of cardiac abnormality, of which 12 were classified as grade 3 LVEF dysfunction and/or congestive heart failure (CHF) (6.9%).
Significant univariate associations for predictors of CHF were history of hypertension, history of coronary heart disease, and prior treatment with an angiotensin-converting enzyme inhibitor.
Multivariate analysis suggested that a history of coronary artery disease and hypertension was the only significant independent predictors of CHF.

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