Document Detail

Cardiovascular toxicity following sunitinib therapy in metastatic renal cell carcinoma: a multicenter analysis.
MedLine Citation:
PMID:  19474115     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Recent data have shown that cardiotoxicity represents a potentially important side-effect in patients treated with sunitinib. We reviewed cardiac adverse events in patients with metastatic renal cell carcinoma (RCC) who underwent treatment with this agent. PATIENTS AND METHODS: The medical records of 175 patients with metastatic RCC treated with sunitinib at eight Italian institutions were retrospectively reviewed. Alterations in left ventricular ejection fraction (LVEF) and blood pressure were evaluated. Patients with preexisting cardiac risk factors were specifically scrutinized for increased expression of cardiac changes. RESULTS: Grade 3 hypertension was seen in 17 patients (9.7%); in 12 of these 17, hypertension developed after receiving the third sunitinib cycle. Among these 17 patients, 12 (70.6%) also experienced left ventricular systolic (LVEF) dysfunction; in all, 33 of the 175 patients (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 (P = 0.008), history of coronary heart disease (P = 0.0005) and prior treatment with an angiotensin-converting enzyme inhibitor (P = 0.04). Multivariate analysis suggested that a history of coronary artery disease [odds ratio (OR) 18, 95% confidence interval (CI) 4-160, P = 0.005] and hypertension (OR 3, 95% CI 1.5-80, P = 0.04) was the only significant independent predictors of CHF. CONCLUSIONS: Patients 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 LVEF dysfunction during treatment.
G Di Lorenzo; R Autorino; G Bruni; G Cartenì; E Ricevuto; M Tudini; C Ficorella; C Romano; M Aieta; A Giordano; M Giuliano; A Gonnella; C De Nunzio; M Rizzo; V Montesarchio; M Ewer; S De Placido
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Publication Detail:
Type:  Journal Article; Multicenter Study     Date:  2009-05-27
Journal Detail:
Title:  Annals of oncology : official journal of the European Society for Medical Oncology / ESMO     Volume:  20     ISSN:  1569-8041     ISO Abbreviation:  Ann. Oncol.     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-25     Completed Date:  2009-11-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9007735     Medline TA:  Ann Oncol     Country:  England    
Other Details:
Languages:  eng     Pagination:  1535-42     Citation Subset:  IM    
Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Università Federico II, Napoli.
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MeSH Terms
Aged, 80 and over
Antineoplastic Agents / adverse effects*
Carcinoma, Renal Cell / complications,  drug therapy*
Coronary Disease / complications
Heart / drug effects*
Hypertension / chemically induced,  complications
Indoles / adverse effects*
Kidney Neoplasms / complications,  drug therapy*
Middle Aged
Pyrroles / adverse effects*
Retrospective Studies
Risk Factors
Stroke Volume / drug effects
Ventricular Function, Left / drug effects
Reg. No./Substance:
0/Antineoplastic Agents; 0/Indoles; 0/Pyrroles; 0/sunitinib

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