title: Heart failure associated with sunitinib malate: a multitargeted receptor tyrosine kinase inhibitor.
abstract: BACKGROUND
  Sunitinib malate is a novel multitargeted receptor tyrosine kinase inhibitor with established efficacy in the treatment of metastatic renal cell carcinoma and imatinib-resistant gastrointestinal stromal tumor. This report describes the development of heart failure in cancer patients who received this novel agent.
  
  
  METHODS
  A retrospective study was conducted at M. D. Anderson Cancer Center during a 1-year period on patients who received sunitinib and developed heart failure.
  
  
  RESULTS
  During 2006, 6 of 224 (2.7%) patients who received sunitinib developed heart failure (HF) that resulted in substantial morbidity and, in some cases, mortality. Symptomatic heart failure occurred soon after initiation of sunitinib (mean onset 22 days after initiation), was associated with decline in cardiac function and elevations in blood pressure, and was not completely reversible in most patients, even after termination of sunitinib therapy.
  
  
  CONCLUSIONS
  These observations suggested that sunitinib-associated heart failure may represent a potentially serious toxicity and underscore the need for careful monitoring of cardiac function and aggressive control of hypertension in these patients. Studies to elucidate potential mechanisms of heart failure and left ventricular dysfunction resulting from treatment with sunitinib are necessary to develop strategies for prevention and treatment of this complication.
authors.affiliation: Department of Cardiology, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. aykhakoo@mdanderson.org
authors.forename: Aarif Y
authors.initials: AY
authors.lastname: Khakoo
authors.forename: Christos M
authors.initials: CM
authors.lastname: Kassiotis
authors.forename: Nizar
authors.initials: N
authors.lastname: Tannir
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Plana
authors.forename: Marc
authors.initials: M
authors.lastname: Halushka
authors.forename: Courtney
authors.initials: C
authors.lastname: Bickford
authors.forename: Jon
authors.initials: J
authors.lastname: Trent
authors.forename: J Chris
authors.initials: JC
authors.lastname: Champion
authors.forename: Jean-Bernard
authors.initials: JB
authors.lastname: Durand
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Lenihan
mesh_terms: D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D005260:Female; D006333:Heart Failure / Q000139:chemically induced*; D006801:Humans; D007211:Indoles / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000009:adverse effects*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors; D011758:Pyrroles / Q000009:adverse effects*; D012189:Retrospective Studies; D000077210:Sunitinib
chemical_list: D000970:Antineoplastic Agents; D007211:Indoles; D047428:Protein Kinase Inhibitors; D011758:Pyrroles; D011505:Protein-Tyrosine Kinases; D000077210:Sunitinib