Arterial hypertension related to sunitinib Review article
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Published:
Sep 30, 2011
Keywords:
iatrogenic arterial hypertension, sunitinib, antiangogenic therapy, cardiotoxcity, antihypertensive treatment, predictive factor
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Abstract
Hypertension is a common concomitant disease in patients with renal carcinoma and a frequent complication of sunitinib therapy. Blocking of VEGF-dependent pathway leads to endothelial dysfunction, reduced nitric oxide production and reduced microvascular density. Clinically, this results in increased peripheral vascular resistance and consequently increase in blood pressure. The diagnosis of iatrogenic arterial hypertension should be in accordance with the guidelines of the European Society of Hypertension and the Polish Society of Hypertension. Home blood pressure measurements are very useful but 24-hour ambulatory blood pressure monitoring is necessary in some cases. Early diagnosis of iatrogenic hypertension gives opportunity to apply the optimal antihypertensive treatment and to prevent cardiotoxicity. When choosing antihypertensive agents it is important to be awared of coexisting diseases, these drugs should not interact with sunitinib. Hypertension related to sunitinib is the positive predictive factor of anticancer therapy and that is why sunitinib discontinuation due to hypertension should be very rare.
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Szmit S, Filipiak KJ, Zaborowska M, Gębara-Puchniarz A, Szczylik C. Arterial hypertension related to sunitinib. OncoReview [Internet]. 2011Sep.30 [cited 2024Jul.23];1(3(3):202-16. Available from: https://journalsmededu.pl/index.php/OncoReview/article/view/257
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Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)
References
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11. Mourad J.J., des Guetz G., Debbabi H., Levy B.I.: Blood pressure rise following angiogenesis inhibition by bevacizumab. A crucial role for microcirculation. Ann. Oncol. 2008; 19: 927-934.
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28. Mancia G., De Backer G., Dominiczak A. et al.; ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension J. Hypertens. 2007 Sep; 25(9): 1751-62.
29. Widecka K., Grodzicki T., Narkiewicz K., Tykarski A., Dziwura J.: Zasady postępowania w nadciśnieniu tętniczym – 2011 rok. Wytyczne Polskiego Towarzystwa Nadciśnienia Tętniczego. Nadciśnienie tętnicze 2011; 15(2): 55-82.
30. Bhojani N., Jeldres C., Patard J.J., Perrotte P., Suardi N., Hutterer G. et al.: Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma. Eur. Urol. 2008; 53: 917-930.
31. Maitland M.L., Bakris G.L., Black H.R., Chen H.X., Durand J.B., Elliott W.J., Ivy S.P., Leier C.V., Lindenfeld J., Liu G., Remick S.C., Steingart R., Tang W.H.; Cardiovascular Toxicities Panel, Convened by the Angiogenesis Task Force of the National Cancer Institute Investigational Drug Steering Committee. Initial assessment, surveillance, and management of blood pressure in patients receiving vascular endothelial growth factor signaling pathway inhibitors. J. Natl. Cancer Inst. 2010 May 5; 102(9): 596-604.
32. Azizi M., Chedid A., Oudard S.: Home blood-pressure monitoring in patients receiving sunitinib. N. Engl. J. Med. 2008; 358(1): 95-97.
33. Maitland M.L., Kasza K.E., Karrison T.G. et al.: Ambulatory monitoring detects sorafenib-induced blood pressure elevations on the first day of treatment. Clin. Cancer Res. 2009; 15(19): 6250-6257.
34. Bamias A., Lainakis G., Manios E., Koroboki E., Gyftaki R., Zakopoulos N., Dimopoulos M.A.: Diagnosis and management of hypertension in advanced renal cell carcinoma: prospective evaluation of an algorithm in patients treated with sunitinib. J. Chemother. 2009 Jun; 21(3): 347-50.
35. Lainakis G., Bamias A., Manios E. et al.: 24-hour arterial blood pressure monitoring in patients with renal cell carcinoma treated with sunitinib results in control of hypertension without dose reduction in the majority of patients. Ann. Oncol. 2008; 18(suppl; abstr 603P): 195.
36. Houk B.E., Bello C.L., Michaelson M.D., Bukowski R.M., Redman B.G., Hudes G.R. et al.: Exposure-response of sunitinib in metastatic renal carcinoma (mRCC): a population pharmacokinetic/pharmacodynamic (PKPD) approach. J. Clin. Oncol. 2007; 25(suppl 18): 241s.
37. Rini B.I.: Biomarkers: hypertension following anti-angiogenesis therapy. Clin. Adv. Hematol. Oncol. 2010; 8(6): 415-6.
38. Rini B.I., Cohen D.P., Lu D., Chen I., Hariharan S., Gore M.E.: Hypertension (HTN) as a biomarker of efficacy in patients (pts) with metastatic renal cell carcinoma (mRCC) treated with sunitinib. ASCO GU meeting 2010; Abstr 312.
39. Ravaud A., Sire M.: Arterial hypertension and clinical benefit of sunitinib, sorafenib and bevacizumab in first and secondline treatment of metastatic renal cell cancer. Ann. Oncol. 2009; 20: 966-967.
40. Rixe O., Billemont B., Izzedine H.: Hypertension as a predictive factor of sunitinib activity. Ann. Oncol. 2007; 18: 1117.
41. Bono P., Rautiola J., Utriainen T., Joensuu H.: Hypertension as predictor of sunitinib treatment outcome in metastatic renal cell carcinoma. Acta Oncol. 2011; 50(4): 569-73.
42. Rini B.I., Cohen D.P., Lu D.R., Chen I., Hariharan S., Gore M.E., Figlin R.A., Baum M.S., Motzer R.J.: Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J. Natl. Cancer Inst. 2011 May 4; 103(9): 763-73.
43. Szmit S., Langiewicz P., Żołnierek J., Nurzyński P., Zaborowska M., Filipiak K.J., Opolski G., Szczylik C.: Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines. Kidney Blood Press Res. 2011 Aug 18; 35(1): 18-25.
44. Ghoreschi K., Laurence A., O’Shea J.J.: Selectivity and therapeutic inhibition of kinases: to be or not to be? Nat. Immunol. 2009; 10: 356-360.
45. Kerkela R., Woulfe K.C., Durand J.B. et al.: Sunitinib-induced cardiotoxicity is mediated by off-target inhibition of AMP-activated protein kinase. Clin. Transl. Sci. 2009; 2: 15-25.
46. Hsieh P.C., MacGillvray C., Gannon J., Cruz F.U., Lee R.T.: Local controlled intramyocardial delivery of platelet-derived growth factor improves postinfarction ventricular function without pulmonary toxicity. Circulation 2006; 114: 637-44.
47. Khakoo A.Y.: Regulation of hypertrophic responses by PDGFRβ. American Heart Association, Basic Cardiovascular Sciences annual meeting. Lake Las Vegas, NV; 2009 July 21st.
48. Wang C.H., Anderson N., Li S.H. et al.: Stem cell factor deficiency is vasculoprotective: Unraveling a new therapeutic potential of imatinib mesylate. Circ. Res. 2006; 99: 617-625.
49. Steinberg S.F.: PI3King the L-type calcium channel activation mechanism. Circ. Res. 2001; 89: 641-644.
50. Di Lorenzo G., Autorino R., Bruni G. et al.: Cardiovascular toxicity following sunitinib therapy in metastatic renal cell carcinoma: a multicenter analysis. Ann. Oncol. 2009; 20(9): 1535-1542.
51. Bamias A., Lainakis G., Manios E., Koroboki E., Karadimou A., Zakopoulos N., Dimopoulos M.A.: Could rigorous diagnosis and management of hypertension reduce cardiac events in patients with renal cell carcinoma treated with tyrosine kinase inhibitors? J. Clin. Oncol. 2009 May 20; 27(15): 2567-9.
52. Khakoo A.Y., Kassiotis C.M., Tannir N., Plana J.C., Halushka M., Bickford C. et al.: Heart failure associated with sunitinib malate: A multitargeted receptor tyrosine kinase inhibitor. Cancer 2008; 112: 2500-8.
53. Telli M.L., Witteles R.M., Fisher G.A., Srinivas S.: Cardiotoxicity associated with the cancer therapeutic agent sunitinib malate. Ann. Oncol. 2008; 19: 1613-8.
54. Szmit S., Nurzyński P., Szaluś N., Opolski G., Szczylik C.: Reversible myocardial dysfunction in a young woman with metastatic renal cell carcinoma treated with sunitinib. Acta Oncol. 2009; 48(6): 921-5.
55. Schmidinger M., Zielinski C.C., Vogl U.M. et al.: Cardiac toxicity of sunitinib and sorafenib in patients with metastatic renal cell carcinoma. J. Clin. Oncol. 2008; 26: 5204-5212.
56. Jain M., Townsend R.R.: Chemotherapy agents and hypertension: a focus on angiogenesis blockade. Curr. Hypertens. Rep. 2007; 9(4): 320-328.
57. Kollmannsberger C., Soulieres D., Wong R., Scalera A., Gaspo R., Bjarnason G.: Sunitinib therapy for metastatic renal cell carcinoma: recommendations for management of side effects. Cancer Urol. Assoc. J. 2007; 1(Suppl): S41-S54.
58. Lacy C.F., Armstrong L.L., Goldman M.P.: Cytochrome P-450 enzymes and drug metabolism. W: Drug information handbook. Lacy C.F., Armstrong L.L., Goldman M.P (red.). Wyd. 12. Hudson, Ohio: Lexi-Comp; 2004: 1619-1631.
59. Szmit S., Filipiak K.J.: Nadciśnienie jako powikłanie współczesnej farmakoterapii onkologicznej. W: Nadciśnienie tętnicze – co nowego? Kasprzak J.D., Nowicki M. (red.). Cornetis (w druku).
60. Dougall H.T., McLay J.: A comparative review of the adverse effects of calcium antagonists. Drug Saf. 1996; 15: 91-106.
2. Sica D.A.: Angiogenesis inhibitors and hypertension: an emerging issue. J. Clin. Oncol. 2006; 24: 1329-31.
3. Motzer R.J., Rini B.I., Bukowski R.M. et al.: Sunitinib in patients with metastatic renal cell carcinoma. JAMA 2006; 295: 2516-2524.
4. Demetri G.D., van Oosterom A.T., Garrett C.R. et al.: Efficacy and safety of sunitinib in patients with advanced gastrointestinal stromal tumour after failure of imatinib: a randomised controlled trial. Lancet 2006; 368: 1329-38.
5. Motzer R.J., Hutson T.E., Tomczak P. et al.: Sunitinib versus interferon alfa in metastatic renal-cell carcinoma. N. Engl. J. Med. 2007; 356: 115-24.
6. Chu T.F., Rupnick M.A., Kerkela R. et al.: Cardiotoxicity associated with tyrosine kinase inhibitor sunitinib. Lancet 2007; 370: 2011-2019.
7. Zhu X., Stergiopoulos K., Wu S.: Risk of hypertension and renal dysfunction with an angiogenesis inhibitor sunitinib: systematic review and meta-analysis. Acta Oncol. 2009; 48(1): 9-17.
8. Hutson T.E., Figlin R.A., Kuhn J.G., Motzer R.J.: Targeted therapies for metastatic renal cell carcinoma: an overview of toxicity and dosing strategies. Oncologist 2008; 13: 1084-1096.
9. Cancer Therapy Evaluation Program. Common terminology criteria for adverse events version 3.0 (CTCAE). Bethesda: National Cancer Institute 2003. Online: http://ctep.cancer.gov/forms/CTCAEv3.pdf.
10. Folkow B.: ‘Structural factor’ in primary and secondary hypertension. Hypertension 1990; 16: 89-101.
11. Mourad J.J., des Guetz G., Debbabi H., Levy B.I.: Blood pressure rise following angiogenesis inhibition by bevacizumab. A crucial role for microcirculation. Ann. Oncol. 2008; 19: 927-934.
12. Noon J.P., Walker B.R., Webb D.J., Shore A.C., Holton D.W., Edwards H.V. et al.: Impaired microvascular dilation and capillary rarefaction in young adults with a predisposition to high blood pressure. J. Clin. Invest. 1997; 99: 1873-1189.
13. Sane D.C., Anton L., Brosnihan K.P.: Angiogenic growth factors and hypertension. Angiogenesis 2004; 7: 193-201.
14. Eremina V., Jefferson J.A., Kowalewska J. et al.: VEGF inhibition and renal thrombotic microangiopathy. N. Engl. J. Med. 2008; 358: 1129-1136.
15. Alavi A., Hood J.D., Frausto R., Stupack D.G., Cheresh D.A.: Role of RAF in vascular protection from distinct apoptotic stimuli. Science 2003; 301: 94-96.
16. Govindarajan R., Adusumilli J., Baxter D.L., El-Khoueiry A., Harik S.I.: Reversible posterior leukoencephalopathy syndrome induced by RAF kinase inhibitor BAY 43-9006. J. Clin. Oncol. 2006; 24: e48.
17. Kapiteijn E., Brand A., Kroep J., Gelderblom H.: Sunitinid induced hypertension, thrombotic microangiopathy and reversible posterior leukencephalopathy syndrome. Ann. Oncol. 2007; 18: 1745-1747.
18. Sugimoto H., Hamano Y., Charytan D., Cosgrove D., Kieran M., Sudhakar A. et al.: Neutralizations of circulating vascular endothelial growth factor (VEGF) by anti-VEGF antibodies and soluble VEGF receptor 1 (sFlt-1) induces proteinuria. J. Biol. Chem. 2003; 278: 12605-12608.
19. Gibbons G.H., Dzau V.J.: The emerging concept of vascular remodeling. N. Engl. J. Med. 1994; 330: 1431-1438.
20. Bhoola K.D., Figueroa C.D., Worthy K.: Bioregulation of kinins: kallikreins, kininogens, and kininases. Pharmacol. Rev. 1992; 44: 1-80.
21. Minshall R.D., Erdös E.G., Vogel S.M.: Angiotensin I-converting enzyme inhibitors potentiate bradykinin’s inotropic effects independently of blocking its inactivation. Am. J. Cardiol. 1997; 80: 132A-136A.
22. Vallance P., Collier J., Moncada S.: Effects of endothelium-derived nitric oxide on peripheral arteriolar tone in man. Lancet 1989; 2: 997-1000.
23. Gardiner S.M., Compton A.M., Bennett T., Palmer R.M., Moncada S.: Control of regional blood flow by endothelium-derived nitric oxide. Hypertension 1990; 15: 486-492.
24. Horowitz J.R., Rivard A., van der Zee R., Hariawala M., Sheriff D.D., Esakof D.D. et al.: Vascular endothelial growth factor/vascular permeability factor produces nitric oxide-dependent hypotension. Evidence for a maintenance role in quiescent adult endothelium. Arterioscler. Thromb. Vasc. Biol. 1997; 17: 2793-2800.
25. Hood J.D., Meininger C.J., Ziche M., Granger H.J.: VEGF upregulates ecNOS message, protein, and NO production in human endothelial cells. Am. J. Physiol. 1998; 274: H1054-H1058.
26. Gordon M.S., Cunningham D.: Managing patients treated with bevacizumab combination therapy. Oncology 2005; 69: S25-S33.
27. Porta C., Szczylik C.: Tolerability of first-line therapy for metastatic renal cell carcinoma. Cancer Treat. Rev. 2009 May; 35(3): 297-307.
28. Mancia G., De Backer G., Dominiczak A. et al.; ESH-ESC Task Force on the Management of Arterial Hypertension. 2007 ESH-ESC Practice Guidelines for the Management of Arterial Hypertension: ESH-ESC Task Force on the Management of Arterial Hypertension J. Hypertens. 2007 Sep; 25(9): 1751-62.
29. Widecka K., Grodzicki T., Narkiewicz K., Tykarski A., Dziwura J.: Zasady postępowania w nadciśnieniu tętniczym – 2011 rok. Wytyczne Polskiego Towarzystwa Nadciśnienia Tętniczego. Nadciśnienie tętnicze 2011; 15(2): 55-82.
30. Bhojani N., Jeldres C., Patard J.J., Perrotte P., Suardi N., Hutterer G. et al.: Toxicities associated with the administration of sorafenib, sunitinib, and temsirolimus and their management in patients with metastatic renal cell carcinoma. Eur. Urol. 2008; 53: 917-930.
31. Maitland M.L., Bakris G.L., Black H.R., Chen H.X., Durand J.B., Elliott W.J., Ivy S.P., Leier C.V., Lindenfeld J., Liu G., Remick S.C., Steingart R., Tang W.H.; Cardiovascular Toxicities Panel, Convened by the Angiogenesis Task Force of the National Cancer Institute Investigational Drug Steering Committee. Initial assessment, surveillance, and management of blood pressure in patients receiving vascular endothelial growth factor signaling pathway inhibitors. J. Natl. Cancer Inst. 2010 May 5; 102(9): 596-604.
32. Azizi M., Chedid A., Oudard S.: Home blood-pressure monitoring in patients receiving sunitinib. N. Engl. J. Med. 2008; 358(1): 95-97.
33. Maitland M.L., Kasza K.E., Karrison T.G. et al.: Ambulatory monitoring detects sorafenib-induced blood pressure elevations on the first day of treatment. Clin. Cancer Res. 2009; 15(19): 6250-6257.
34. Bamias A., Lainakis G., Manios E., Koroboki E., Gyftaki R., Zakopoulos N., Dimopoulos M.A.: Diagnosis and management of hypertension in advanced renal cell carcinoma: prospective evaluation of an algorithm in patients treated with sunitinib. J. Chemother. 2009 Jun; 21(3): 347-50.
35. Lainakis G., Bamias A., Manios E. et al.: 24-hour arterial blood pressure monitoring in patients with renal cell carcinoma treated with sunitinib results in control of hypertension without dose reduction in the majority of patients. Ann. Oncol. 2008; 18(suppl; abstr 603P): 195.
36. Houk B.E., Bello C.L., Michaelson M.D., Bukowski R.M., Redman B.G., Hudes G.R. et al.: Exposure-response of sunitinib in metastatic renal carcinoma (mRCC): a population pharmacokinetic/pharmacodynamic (PKPD) approach. J. Clin. Oncol. 2007; 25(suppl 18): 241s.
37. Rini B.I.: Biomarkers: hypertension following anti-angiogenesis therapy. Clin. Adv. Hematol. Oncol. 2010; 8(6): 415-6.
38. Rini B.I., Cohen D.P., Lu D., Chen I., Hariharan S., Gore M.E.: Hypertension (HTN) as a biomarker of efficacy in patients (pts) with metastatic renal cell carcinoma (mRCC) treated with sunitinib. ASCO GU meeting 2010; Abstr 312.
39. Ravaud A., Sire M.: Arterial hypertension and clinical benefit of sunitinib, sorafenib and bevacizumab in first and secondline treatment of metastatic renal cell cancer. Ann. Oncol. 2009; 20: 966-967.
40. Rixe O., Billemont B., Izzedine H.: Hypertension as a predictive factor of sunitinib activity. Ann. Oncol. 2007; 18: 1117.
41. Bono P., Rautiola J., Utriainen T., Joensuu H.: Hypertension as predictor of sunitinib treatment outcome in metastatic renal cell carcinoma. Acta Oncol. 2011; 50(4): 569-73.
42. Rini B.I., Cohen D.P., Lu D.R., Chen I., Hariharan S., Gore M.E., Figlin R.A., Baum M.S., Motzer R.J.: Hypertension as a biomarker of efficacy in patients with metastatic renal cell carcinoma treated with sunitinib. J. Natl. Cancer Inst. 2011 May 4; 103(9): 763-73.
43. Szmit S., Langiewicz P., Żołnierek J., Nurzyński P., Zaborowska M., Filipiak K.J., Opolski G., Szczylik C.: Hypertension as a Predictive Factor for Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma Treated with Sunitinib after Progression on Cytokines. Kidney Blood Press Res. 2011 Aug 18; 35(1): 18-25.
44. Ghoreschi K., Laurence A., O’Shea J.J.: Selectivity and therapeutic inhibition of kinases: to be or not to be? Nat. Immunol. 2009; 10: 356-360.
45. Kerkela R., Woulfe K.C., Durand J.B. et al.: Sunitinib-induced cardiotoxicity is mediated by off-target inhibition of AMP-activated protein kinase. Clin. Transl. Sci. 2009; 2: 15-25.
46. Hsieh P.C., MacGillvray C., Gannon J., Cruz F.U., Lee R.T.: Local controlled intramyocardial delivery of platelet-derived growth factor improves postinfarction ventricular function without pulmonary toxicity. Circulation 2006; 114: 637-44.
47. Khakoo A.Y.: Regulation of hypertrophic responses by PDGFRβ. American Heart Association, Basic Cardiovascular Sciences annual meeting. Lake Las Vegas, NV; 2009 July 21st.
48. Wang C.H., Anderson N., Li S.H. et al.: Stem cell factor deficiency is vasculoprotective: Unraveling a new therapeutic potential of imatinib mesylate. Circ. Res. 2006; 99: 617-625.
49. Steinberg S.F.: PI3King the L-type calcium channel activation mechanism. Circ. Res. 2001; 89: 641-644.
50. Di Lorenzo G., Autorino R., Bruni G. et al.: Cardiovascular toxicity following sunitinib therapy in metastatic renal cell carcinoma: a multicenter analysis. Ann. Oncol. 2009; 20(9): 1535-1542.
51. Bamias A., Lainakis G., Manios E., Koroboki E., Karadimou A., Zakopoulos N., Dimopoulos M.A.: Could rigorous diagnosis and management of hypertension reduce cardiac events in patients with renal cell carcinoma treated with tyrosine kinase inhibitors? J. Clin. Oncol. 2009 May 20; 27(15): 2567-9.
52. Khakoo A.Y., Kassiotis C.M., Tannir N., Plana J.C., Halushka M., Bickford C. et al.: Heart failure associated with sunitinib malate: A multitargeted receptor tyrosine kinase inhibitor. Cancer 2008; 112: 2500-8.
53. Telli M.L., Witteles R.M., Fisher G.A., Srinivas S.: Cardiotoxicity associated with the cancer therapeutic agent sunitinib malate. Ann. Oncol. 2008; 19: 1613-8.
54. Szmit S., Nurzyński P., Szaluś N., Opolski G., Szczylik C.: Reversible myocardial dysfunction in a young woman with metastatic renal cell carcinoma treated with sunitinib. Acta Oncol. 2009; 48(6): 921-5.
55. Schmidinger M., Zielinski C.C., Vogl U.M. et al.: Cardiac toxicity of sunitinib and sorafenib in patients with metastatic renal cell carcinoma. J. Clin. Oncol. 2008; 26: 5204-5212.
56. Jain M., Townsend R.R.: Chemotherapy agents and hypertension: a focus on angiogenesis blockade. Curr. Hypertens. Rep. 2007; 9(4): 320-328.
57. Kollmannsberger C., Soulieres D., Wong R., Scalera A., Gaspo R., Bjarnason G.: Sunitinib therapy for metastatic renal cell carcinoma: recommendations for management of side effects. Cancer Urol. Assoc. J. 2007; 1(Suppl): S41-S54.
58. Lacy C.F., Armstrong L.L., Goldman M.P.: Cytochrome P-450 enzymes and drug metabolism. W: Drug information handbook. Lacy C.F., Armstrong L.L., Goldman M.P (red.). Wyd. 12. Hudson, Ohio: Lexi-Comp; 2004: 1619-1631.
59. Szmit S., Filipiak K.J.: Nadciśnienie jako powikłanie współczesnej farmakoterapii onkologicznej. W: Nadciśnienie tętnicze – co nowego? Kasprzak J.D., Nowicki M. (red.). Cornetis (w druku).
60. Dougall H.T., McLay J.: A comparative review of the adverse effects of calcium antagonists. Drug Saf. 1996; 15: 91-106.