Abstract
Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1⁻T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1⁻T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population.
| Original language | English |
|---|---|
| Journal | Cancers |
| Volume | 11 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Dec 28 2018 |
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Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer. / Dalbeni, Andrea; Ciccarese, Chiara; Bevilacqua, Michele; Benati, Marco; Caimmi, Cristian; Cerrito, Luca; Famà, Federico; Iacovelli, Roberto; Mantovani, Anna; Meneguzzi, Francesco Massari Alessandra; Minuz, Pietro; Montagnana, Martina; Orsolini, Giovanni; Rossini, Maurizio; Tortora, Giampaolo; Viapiana, Ombretta; Fava, Cristiano.
In: Cancers, Vol. 11, No. 1, 28.12.2018.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
AU - Dalbeni, Andrea
AU - Ciccarese, Chiara
AU - Bevilacqua, Michele
AU - Benati, Marco
AU - Caimmi, Cristian
AU - Cerrito, Luca
AU - Famà, Federico
AU - Iacovelli, Roberto
AU - Mantovani, Anna
AU - Meneguzzi, Francesco Massari Alessandra
AU - Minuz, Pietro
AU - Montagnana, Martina
AU - Orsolini, Giovanni
AU - Rossini, Maurizio
AU - Tortora, Giampaolo
AU - Viapiana, Ombretta
AU - Fava, Cristiano
PY - 2018/12/28
Y1 - 2018/12/28
N2 - Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1⁻T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1⁻T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population.
AB - Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1⁻T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1⁻T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population.
U2 - 10.3390/cancers11010030
DO - 10.3390/cancers11010030
M3 - Article
C2 - 30597890
VL - 11
JO - Cancers
JF - Cancers
SN - 2072-6694
IS - 1
ER -