Relationship between treatment-related hypertension and therapeutic efficacy of vascular endothelial growth factor receptor tyrosine kinase inhibitors in metastatic renal cell carcinoma
10.3760/cma.j.issn.0253-3766.2016.09.012
- VernacularTitle:治疗相关高血压与血管内皮生长因子受体酪氨酸激酶抑制剂治疗转移性肾细胞癌疗效的关系
- Author:
Yan SONG
1
;
Chunxia DU
;
Wen ZHANG
;
Yongkun SUN
;
Lin YANG
;
Chengxu CUI
;
Yihebali CHI
;
Aiping ZHOU
;
Jinwan WANG
;
Yan SUN
Author Information
1. 100021,国家癌症中心 中国医学科学院北京协和医学院肿瘤医院内科
- Keywords:
Carcinoma,renal cell;
Hypertension;
Receptor,vascular endothelial growth factor;
Tyrosine kinase inhibitor;
Treatment outcome;
Prognosis
- From:
Chinese Journal of Oncology
2016;38(9):698-702
- CountryChina
- Language:Chinese
-
Abstract:
Objective Vascular endothelial growth factor receptor?tyrosine kinase inhibitors (VEGFR?TKIs) are widely used for the treatment of metastatic renal cell carcinoma (mRCC). The aim of this study was to investigate the association between treatment?related hypertension and the therapeutic efficacy of VEGFR?TKIs. Methods Clinical data of 155 mRCC patients treated with VEGFR?TKIs at the Cancer Hospital of Chinese Academy of Medical Sciences from 2006 to 2014 were retrospectively analyzed. All patients received first?line TKI therapy. Among them, 69 patients were treated with sunitinib, 14 cases with pazopanib, and 51 cases with fazotinib. Kaplan?Meier curves were used to evaluate the survival of the patients. Results The median survival for the whole group ( n=155) was 36. 2 months. Among the 98 (63.2%) patients who developed hypertension, 9 patients (5.8%) were evaluated as gradeⅠ, 54 (34.8%) as grade Ⅱ and 35 (22.6%) as gradeⅢ, and there was no patient with gradeⅣhypertension. The occurrence of TKI?related hypertension was correlated with age and MSKCC score (P<0.05), while not significantly correlated with gender, nephrectomy, T stage, number of metastases, lung metastasis or sunitinib treatment (P>0.05 for all). For the whole group (n=155), the therapeutic efficacy rate was 43.2% (67/155), the median progression?free survival (PFS) was 12.0 months, and the median overall survival (OS) was 36.2 months. The response rate (RR) was 26.3% (15/57) in patients with normal blood pressure and 53.1%(52/98) in patients with hypertension (P=0.001). The median PFS was 7.1 months in the cases with normal blood pressure and 13.8 months in patients with hypertension (P=0.032). The response rates were 33.3% (3/9), 51.9% (28/54) and 60.0% (21/35) in patients with grade Ⅰ, Ⅱ and Ⅲ hypertension (P=0.006). The median PFS was 7.1, 9.7, and 12.0 and 19.5 months in patients with normal blood pressure, and patients with grade Ⅰ, Ⅱ and Ⅲ hypertension, respectively (P=0.039). Both univariant and multivariant analyses indicated that treatment?related hypertension is an important predictive factor for the efficacy of VEGFR?TKIs therapy. Conclusions Hypertension might be an effective predictive factor for efficacy of VEGFR?TKIs therapy in mRCC patients. Large?sample studies are warranted to further prove these results.
