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Vascular Endothelial Growth Factor Inhibitor Therapy and Cardiovascular and Renal Damage in Renal Cell Carcinoma

[ Vol. 16 , Issue. 2 ]

Author(s):

Silvia Lai*, Alessio Molfino, Patrizia Seminara, Flavia Longo, Georgie Innico, Bettina Coppola, Daniela Mastroluca, Alessandro Galani , Mira Dimko, Paola Aceto and Carlo Lai   Pages 190 - 196 ( 7 )

Abstract:


Background: Sunitinib, a tyrosine kinase inhibitor of vascular endothelial growth factor (VEGF), is approved for first and second line treatment of advanced renal cell carcinoma (RCC). Knowledge on the effects of sunitinib on cardiovascular (CV) risk and renal damage is limited.

Aim: To evaluate possible renal and CV damage in patients with RCC treated with sunitinib.

Materials and Methods: Patients with metastatic RCC treated with sunitinib were enrolled. This population was evaluated before starting treatment (T0) and after 3 months (T1). Laboratory and instrumental parameters, including interventricular septum (IVS) and left ventricular mass index (LVMI) were recorded before and after treatment.

Results: Thirty-two patients (13 female, 19 male, mean age 62.7±9.9 years) were enrolled. We observed overtime, a significant reduction in estimated glomerular filtration rate (eGFR) (p=0.01), hemoglobin (Hb) (p=0.04) and 25-hydroxyvitamin D (25-OH-VitD) (p=0.002), in association with a significant increase in serum phosphorus (p<0.001), systolic blood pressure (SBP) (p<0.001), diastolic blood pressure (DBP) (p<0.001), IVS (p=0.03) and proteinuria (p<0.001), while we showed no significant differences in glycosuria, phosphaturia, serum uric acid, intact parathormone, and LVMI.

Conclusion: We observed the development of renal damage and worsening of CV indices in patients treated with sunitinib. We suggest to consider a careful assessment of renal function and CV risk factors, before initiation and during administration of this drug.

Keywords:

Sunitinib, renal cell carcinoma, chronic kidney disease, hypertension, proteinuria, cardiovascular risk.

Affiliation:

Department of Clinical Medicine, Sapienza University of Rome, Rome, Department of Clinical Medicine, Sapienza University of Rome, Rome, Medical Oncology Department, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Medical Oncology Department, Policlinico Umberto I Hospital, Sapienza University of Rome, Rome, Department of Medicine DIMED, School of Specialization in Nephrology, University of Padova, Padova, Dialysis Unit, San Giovanni Evangelista Hospital, Tivoli, Nephrology and Dialysis Unit, ICOT Hospital, Latina, Sapienza University of Rome, Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Department of Internal Medicine, Clinical Institute San Rocco, Brescia, Department of Anaesthesia and Intensive care, Catholic University of Sacred Heart Rome, Department of Dynamic and Clinic Psychology, Sapienza University of Rome, Rome

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