Drug-Induced Hypertension Caused by Multikinase Inhibitors (Sorafenib, Sunitinib, Lenvatinib and Axitinib) in Renal Cell Carcinoma Treatment.
Nanna Bæk MøllerCecilie BudolfsenDaniela GrimmMarcus KrügerManfred InfangerMarkus WehlandNils E MagnussonPublished in: International journal of molecular sciences (2019)
This paper reviews current treatments for renal cell carcinoma/cancer (RCC) with the multikinase inhibitors (MKIs) sorafenib, sunitinib, lenvatinib and axitinib. Furthermore, it compares these drugs regarding progression-free survival, overall survival and adverse effects (AE), with a focus on hypertension. Sorafenib and sunitinib, which are included in international clinical guidelines as first- and second-line therapy in metastatic RCC, are now being challenged by new-generation drugs like lenvatinib and axitinib. These drugs have shown significant clinical benefits for patients with RCC, but all four induce a variety of AEs. Hypertension is one of the most common AEs related to MKI treatment. Comparing sorafenib, sunitinib and lenvatinib revealed that sorafenib and sunitinib had the same efficacy, but sorafenib was safer to use. Lenvatinib showed better efficacy than sorafenib but worse safety. No trials have yet been completed that compare lenvatinib with sunitinib. Although axitinib promotes slightly higher hypertension rates compared to sunitinib, the overall discontinuation rate and cardiovascular complications are favourable. Although the mean rate of patients who develop hypertension is similar for each drug, some trials have shown large differences, which could indicate that lifestyle and/or genetic factors play an additional role.
Keyphrases
- renal cell carcinoma
- metastatic renal cell carcinoma
- blood pressure
- drug induced
- liver injury
- free survival
- squamous cell carcinoma
- small cell lung cancer
- physical activity
- stem cells
- type diabetes
- gene expression
- genome wide
- clinical practice
- systematic review
- dna methylation
- papillary thyroid
- bone marrow
- replacement therapy
- smoking cessation
- meta analyses