Cardiovascular comorbidities for prediction of progression-free survival in patients with metastatic renal cell carcinoma treated with sorafenib.
OBJECTIVE
The purpose of the present study was to determine the relationship between iatrogenic arterial hypertension or baseline cardiovascular comorbidities and outcomes in metastatic renal cell cancer (mRCC) patients treated with sorafenib.


METHODS
The study included 148 mRCC patients treated with sorafenib, 63 patients (43%) had preexisting hypertension, 18 patients (12%) coronary artery disease, and 15 patients (10%) mild heart failure. Resting blood pressure (BP) was monitored by clinic and home measurements. Sorafenib-induced hypertension was defined as systolic BP ≥140 and/or diastolic BP ≥90 mm Hg during the first month of treatment.


RESULTS
Preexisting cardiovascular comorbidities were not associated with worsening prognosis of patients with mRCC treated with sorafenib. During the first month of treatment, sorafenib-induced hypertension was diagnosed in 76 patients (51.4%), and these patients had a significantly longer PFS (p < 0.00001) and a significantly lower overall mortality risk (p = 0.038). Patients with preexisting and sorafenib-induced hypertension had the longest PFS (p < 0.00001).


CONCLUSIONS
Sorafenib-induced hypertension is a positive predictive factor in mRCC patients treated with sorafenib, especially in patients with a history of hypertension.
Department of Oncology, Military Institute of Medicine, Warsaw, Poland. s.szmit @ gmail.com
Sebastian
S
Szmit
Magdalena
M
Zaborowska
Anna
A
Waśko-Grabowska
Jakub
J
Żołnierek
Paweł
P
Nurzyński
Krzysztof J
KJ
Filipiak
Grzegorz
G
Opolski
Cezary
C
Szczylik
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects*; D002292:Carcinoma, Renal Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009536:Niacinamide / Q000009:adverse effects / Q000031:analogs & derivatives*; D010671:Phenylurea Compounds / Q000009:adverse effects*; D011237:Predictive Value of Tests; D000077157:Sorafenib; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D010671:Phenylurea Compounds; D009536:Niacinamide; D000077157:Sorafenib