肝细胞癌治疗lenvatinib后血压升高:一个潜在的标志物更好的预后
Keisuke Shibata1, Yuichi Akasaki2, Akihiro Tokushige3,4
1Department of Cardiovascular Medicine and Hypertension, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima, Japan.
开始使用伦瓦提尼布 (一种氨酸激酶抑制剂) 后早期血压升高与癌症患者的生存率改善有关. 这一发现表明,监测血压可以帮助预测患者的结果.
科学领域:
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
- 心脏病学 心脏病学
背景情况:
- 伦瓦提尼布是一种氨酸激酶抑制剂,通过抑制血管内皮生长因子信号传递来治疗肝细胞癌.
- 高血压是血管新生抑制剂 (如伦瓦提尼布) 的常见副作用.
- 有限的研究探讨了伦瓦替尼布诱导的高血压的预后价值.
研究的目的:
- 为了研究伦瓦提尼布开始后血压升高与患者结果之间的关系.
- 为了确定早期血压变化是否可以作为接受伦瓦替尼治疗的患者的预后标记.
主要方法:
- 在鹿児島大學醫院 (2018年5月至2023年12月) 治療lenvatinib的67名患者的回顧性分析.
- 监测血压变化从入院通过住院后的伦瓦提尼布管理.
- 将患者分为血压升高 (≥26 mmHg升高) 和非升高组.
- 统计分析,包括日志等级测试和调整模型,以比较死亡率.
主要成果:
- 伦瓦提尼布 (lenvatinib) 给药后的第二天观察到显著的血压升高 (中位数为136/76 mmHg).
- 3级高血压 (≥160/100mmHg) 在37.3%的患者中发生.
- 血压升高 (≥26 mmHg升高) 患者的死亡率明显降低 (35.3%与81.8%,p=0.007),即使在调整后.
- 39%的患者加强了抗高血压治疗,12%的患者在出院前仍患有3级高血压.
结论:
- 伦瓦提尼布开始使用后,早期和显著的血压升高与改善的整体存活率有关.
- 伦瓦提尼布治疗后血压变化可能成为癌症患者的宝贵预后指标.
- 需要进一步的研究来证实这些发现,并优化林瓦提尼布治疗患者的高血压管理.
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