Plasma N-terminal pro-brain natriuretic peptide as prognostic marker in fatal cardial decompensation with sunitinib malate therapy.
A 74-year-old man with metastatic renal cell carcinoma and a history of cardiac failure was treated with sunitinib malate. MUGA echocardiography could not detect a relevant change in the ejection fraction although the clinical situation of the patient worsened dramatically. The only parameter to hint at the deteriorated cardiac function was plasma N-terminal pro-brain natriuretic peptide (BNP). Finally, the patient died after only one cycle of sunitinib treatment. We propose to prospectively include BNP for the early detection of cardiovascular decompensation in high-risk patients. Future studies concerning the relevance of BNP in drug-related cardiotoxicity are urgently needed.
Staehler
Michael
M
Department of Urology, University of Munich, Klinikum Grosshadern, Marchioninistrasse 15, DE-81377 Munich, Germany. michael.staehler@med.uni-muenchen.de
Haseke
Nicolas
N
Zilinberg
Katja
K
Stadler
Thomas
T
Stief
Christian G
CG
D000368:Aged; D002292:Carcinoma, Renal Cell / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D004452:Echocardiography / Q000379:methods; D006333:Heart Failure / Q000097:blood* / Q000188:drug therapy*; D006801:Humans; D007211:Indoles / Q000627:therapeutic use*; D007680:Kidney Neoplasms / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D008175:Lung Neoplasms / Q000556:secondary; D008297:Male; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009362:Neoplasm Metastasis; D011379:Prognosis; D011758:Pyrroles / Q000627:therapeutic use*; D012189:Retrospective Studies; D000077210:Sunitinib; D013927:Thrombosis / Q000473:pathology
D007211:Indoles; D011758:Pyrroles; D020097:Natriuretic Peptide, Brain; D000077210:Sunitinib