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Risk of hypertension and renal dysfunction with an angiogenesis inhibitor sunitinib: systematic review and

Xiaolei Zhu1, Kathleen Stergiopoulos, Shenhong Wu

  • 1Kidney Specialists of Long Island, Port Jefferson Station, NY, USA.

Acta Oncologica (Stockholm, Sweden)
|August 30, 2008
PubMed
Abstract

Insights

Sunitinib treatment significantly increases the risk of hypertension and renal dysfunction in cancer patients. Close monitoring and management of blood pressure are crucial for those undergoing sunitinib therapy.

Area of Science:

  • Oncology
  • Pharmacology
  • Clinical Trials

Background:

  • Sunitinib is a tyrosine kinase inhibitor used for metastatic renal cell carcinoma (RCC) and gastrointestinal stromal tumor (GIST).
  • Hypertension is a known side effect of sunitinib, with variable reported incidences.
  • This study aimed to determine the overall risk of hypertension associated with sunitinib.

Purpose of the Study:

  • To conduct a systematic review and meta-analysis of clinical trials on sunitinib.
  • To quantify the incidence and relative risk of hypertension in patients treated with sunitinib.
  • To assess the risk of renal dysfunction associated with sunitinib therapy.

Main Methods:

  • Systematic search of MEDLINE, Web of Science, and ASCO abstracts (2004-2007).
  • Inclusion of prospective clinical trials of single-agent sunitinib with reported hypertension events.
  • Calculation of incidence and relative risk using random-effects or fixed-effects models.

Main Results:

  • Analysis included 4,999 patients from 13 clinical trials.
  • Overall incidence of all-grade and high-grade hypertension were 21.6% and 6.8%, respectively.
  • Sunitinib significantly increased the risk of high-grade hypertension (RR=22.72) and renal dysfunction (RR=1.36).

Conclusions:

  • Sunitinib therapy poses a significant risk for developing hypertension and renal dysfunction.
  • Close monitoring of blood pressure is recommended for patients on sunitinib.
  • Management strategies for sunitinib-induced hypertension should be implemented.

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