title: Influence of Tyrosine Kinase Inhibitors on Hypertension and Nephrotoxicity in Metastatic Renal Cell Cancer Patients.
abstract: Renal cell carcinoma (RCC) is one of the most common kidney malignancies. An upgraded comprehension of the molecular biology implicated in the development of cancer has stimulated an increase in research and development of innovative antitumor therapies. The aim of the study was to analyze the medical literature for hypertension and renal toxicities as the adverse events of the vascular endothelial growth factor (VEGF) signaling pathway inhibitor (anti-VEGF) therapy. Relevant studies were identified in PubMed and ClinicalTrials.gov databases. Eligible studies were phase III and IV prospective clinical trials, meta-analyses and retrospective studies that had described events of hypertension or nephrotoxicity for patients who received anti-VEGF therapy. A total of 48 studies were included in the systematic review. The incidence of any grade hypertension ranged from 17% to 49.6%. Proteinuria and increased creatinine levels were ascertained in 8% to 73% and 5% to 65.6% of patients, respectively. These adverse events are most often mild in severity but may sometimes lead to treatment discontinuation. Nephrotoxicity and hypertension are related to multiple mechanisms; however, one of the main disturbances in those patients is VEGF inhibition. There is a significant risk of developing hypertension and renal dysfunction among patients receiving anti-VEGF treatment; however, there is also some evidence that these side effects may be used as biomarkers of response to antiangiogenic agents.
authors.affiliation: Military Institute of Medicine Szaserów, 128 Street, 04-141 Warsaw, Poland. asemeniuk@wim.mil.pl.
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Semeniuk-Wojtaś
authors.affiliation: Military Institute of Medicine Szaserów, 128 Street, 04-141 Warsaw, Poland. alubas@wim.mil.pl.
authors.forename: Arkadiusz
authors.initials: A
authors.lastname: Lubas
authors.affiliation: Military Institute of Medicine Szaserów, 128 Street, 04-141 Warsaw, Poland. rstec@wim.mil.pl.
authors.forename: Rafał
authors.initials: R
authors.lastname: Stec
authors.affiliation: Military Institute of Medicine Szaserów, 128 Street, 04-141 Warsaw, Poland. cszczylik@wim.mil.pl.
authors.forename: Cezary
authors.initials: C
authors.lastname: Szczylik
authors.affiliation: Military Institute of Medicine Szaserów, 128 Street, 04-141 Warsaw, Poland. sniemczyk@wim.mil.pl.
authors.forename: Stanisław
authors.initials: S
authors.lastname: Niemczyk
mesh_terms: D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000818:Animals; D002292:Carcinoma, Renal Cell / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000201:enzymology; D007680:Kidney Neoplasms / Q000188:drug therapy* / Q000201:enzymology; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use*; D011505:Protein-Tyrosine Kinases / Q000037:antagonists & inhibitors*
chemical_list: D020533:Angiogenesis Inhibitors; D047428:Protein Kinase Inhibitors; D011505:Protein-Tyrosine Kinases
keywords: hypertension; nephrotoxicity; renal cell carcinoma; tyrosine kinase inhibitor