PMID- 19474115
OWN - NLM
STAT- MEDLINE
DCOM- 20091109
LR  - 20200619
IS  - 1569-8041 (Electronic)
IS  - 0923-7534 (Linking)
VI  - 20
IP  - 9
DP  - 2009 Sep
TI  - Cardiovascular toxicity following sunitinib therapy in metastatic renal cell 
      carcinoma: a multicenter analysis.
PG  - 1535-1542
LID - S0923-7534(19)40436-5 [pii]
LID - 10.1093/annonc/mdp025 [doi]
AB  - BACKGROUND: Recent data have shown that cardiotoxicity represents a potentially 
      important side-effect in patients treated with sunitinib. We reviewed cardiac 
      adverse events in patients with metastatic renal cell carcinoma (RCC) who 
      underwent treatment with this agent. PATIENTS AND METHODS: The medical records of 
      175 patients with metastatic RCC treated with sunitinib at eight Italian 
      institutions were retrospectively reviewed. Alterations in left ventricular 
      ejection fraction (LVEF) and blood pressure were evaluated. Patients with 
      preexisting cardiac risk factors were specifically scrutinized for increased 
      expression of cardiac changes. RESULTS: Grade 3 hypertension was seen in 17 
      patients (9.7%); in 12 of these 17, hypertension developed after receiving the 
      third sunitinib cycle. Among these 17 patients, 12 (70.6%) also experienced left 
      ventricular systolic (LVEF) dysfunction; in all, 33 of the 175 patients (18.9%) 
      developed some degree of cardiac abnormality, of which 12 were classified as 
      grade 3 LVEF dysfunction and/or congestive heart failure (CHF) (6.9%). 
      Significant univariate associations for predictors of CHF were history of 
      hypertension (P = 0.008), history of coronary heart disease (P = 0.0005) and 
      prior treatment with an angiotensin-converting enzyme inhibitor (P = 0.04). 
      Multivariate analysis suggested that a history of coronary artery disease [odds 
      ratio (OR) 18, 95% confidence interval (CI) 4-160, P = 0.005] and hypertension 
      (OR 3, 95% CI 1.5-80, P = 0.04) was the only significant independent predictors 
      of CHF. CONCLUSIONS: Patients undergoing sunitinib, especially those with a 
      previous history of hypertension and coronary heart disease, are at increased 
      risk for cardiovascular events and should be monitored for exacerbations of their 
      hypertension and for evidence of LVEF dysfunction during treatment.
FAU - Di Lorenzo, G
AU  - Di Lorenzo G
AD  - Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Universita 
      Federico II, Napoli. Electronic address: giuseppedilorenzoncol@hotmail.com.
FAU - Autorino, R
AU  - Autorino R
AD  - Clinica Urologica, Seconda Universita degli Studi, Napoli.
FAU - Bruni, G
AU  - Bruni G
AD  - UOC Oncologia, INT Fondazione 'G. Pascale', Napoli.
FAU - Carteni, G
AU  - Carteni G
AD  - UOC Oncologia, Ospedale Cardarelli, Napoli.
FAU - Ricevuto, E
AU  - Ricevuto E
AD  - UO Oncologia, Universita Dell'Aquila, L'Aquila.
FAU - Tudini, M
AU  - Tudini M
AD  - UO Oncologia, Universita Dell'Aquila, L'Aquila.
FAU - Ficorella, C
AU  - Ficorella C
AD  - UO Oncologia, Universita Dell'Aquila, L'Aquila.
FAU - Romano, C
AU  - Romano C
AD  - UO Oncologia, Ospedale Oncologico Regionale, Rionero in Vulture, Potenza.
FAU - Aieta, M
AU  - Aieta M
AD  - UO Oncologia, Ospedale Oncologico Regionale, Rionero in Vulture, Potenza.
FAU - Giordano, A
AU  - Giordano A
AD  - Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Universita 
      Federico II, Napoli.
FAU - Giuliano, M
AU  - Giuliano M
AD  - Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Universita 
      Federico II, Napoli.
FAU - Gonnella, A
AU  - Gonnella A
AD  - Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Universita 
      Federico II, Napoli.
FAU - De Nunzio, C
AU  - De Nunzio C
AD  - UOC Urologia, Ospedale Sant'Andrea, Roma.
FAU - Rizzo, M
AU  - Rizzo M
AD  - UOC Oncologia, Ospedale Cardarelli, Napoli.
FAU - Montesarchio, V
AU  - Montesarchio V
AD  - UO Oncologia, AO 'Cotugno', Napoli, Italy.
FAU - Ewer, M
AU  - Ewer M
AD  - Department of Cardiology, The University of Texas MD Anderson Cancer Center, 
      Houston, TX, USA.
FAU - De Placido, S
AU  - De Placido S
AD  - Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Universita 
      Federico II, Napoli.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20090527
PL  - England
TA  - Ann Oncol
JT  - Annals of oncology : official journal of the European Society for Medical 
      Oncology
JID - 9007735
RN  - 0 (Antineoplastic Agents)
RN  - 0 (Indoles)
RN  - 0 (Pyrroles)
RN  - V99T50803M (Sunitinib)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Antineoplastic Agents/*adverse effects
MH  - Carcinoma, Renal Cell/complications/*drug therapy
MH  - Coronary Disease/complications
MH  - Female
MH  - Heart/*drug effects
MH  - Humans
MH  - Hypertension/chemically induced/complications
MH  - Indoles/*adverse effects
MH  - Kidney Neoplasms/complications/*drug therapy
MH  - Male
MH  - Middle Aged
MH  - Pyrroles/*adverse effects
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Stroke Volume/drug effects
MH  - Sunitinib
MH  - Ventricular Function, Left/drug effects
EDAT- 2009/05/29 09:00
MHDA- 2009/11/10 06:00
CRDT- 2009/05/29 09:00
PHST- 2009/05/29 09:00 [entrez]
PHST- 2009/05/29 09:00 [pubmed]
PHST- 2009/11/10 06:00 [medline]
AID - S0923-7534(19)40436-5 [pii]
AID - 10.1093/annonc/mdp025 [doi]
PST - ppublish
SO  - Ann Oncol. 2009 Sep;20(9):1535-1542. doi: 10.1093/annonc/mdp025. Epub 2009 May 
      27.