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Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer

Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching...

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Autores principales: Dalbeni, Andrea, Ciccarese, Chiara, Bevilacqua, Michele, Benati, Marco, Caimmi, Cristian, Cerrito, Luca, Famà, Federico, Iacovelli, Roberto, Mantovani, Anna, Meneguzzi, Francesco Massari Alessandra, Minuz, Pietro, Montagnana, Martina, Orsolini, Giovanni, Rossini, Maurizio, Tortora, Gianpaolo, Viapiana, Ombretta, Fava, Cristiano
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357121/
https://www.ncbi.nlm.nih.gov/pubmed/30597890
http://dx.doi.org/10.3390/cancers11010030
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author Dalbeni, Andrea
Ciccarese, Chiara
Bevilacqua, Michele
Benati, Marco
Caimmi, Cristian
Cerrito, Luca
Famà, Federico
Iacovelli, Roberto
Mantovani, Anna
Meneguzzi, Francesco Massari Alessandra
Minuz, Pietro
Montagnana, Martina
Orsolini, Giovanni
Rossini, Maurizio
Tortora, Gianpaolo
Viapiana, Ombretta
Fava, Cristiano
author_facet Dalbeni, Andrea
Ciccarese, Chiara
Bevilacqua, Michele
Benati, Marco
Caimmi, Cristian
Cerrito, Luca
Famà, Federico
Iacovelli, Roberto
Mantovani, Anna
Meneguzzi, Francesco Massari Alessandra
Minuz, Pietro
Montagnana, Martina
Orsolini, Giovanni
Rossini, Maurizio
Tortora, Gianpaolo
Viapiana, Ombretta
Fava, Cristiano
author_sort Dalbeni, Andrea
collection PubMed
description Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1–T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1–T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population.
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spelling pubmed-63571212019-02-05 Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer Dalbeni, Andrea Ciccarese, Chiara Bevilacqua, Michele Benati, Marco Caimmi, Cristian Cerrito, Luca Famà, Federico Iacovelli, Roberto Mantovani, Anna Meneguzzi, Francesco Massari Alessandra Minuz, Pietro Montagnana, Martina Orsolini, Giovanni Rossini, Maurizio Tortora, Gianpaolo Viapiana, Ombretta Fava, Cristiano Cancers (Basel) Article Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1–T0 ≥10 and/or SBP ≥140 mmHg and/or diastolic blood pressure (DBP) T1–T0 ≥5 and/or DBP ≥90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population. MDPI 2018-12-28 /pmc/articles/PMC6357121/ /pubmed/30597890 http://dx.doi.org/10.3390/cancers11010030 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Dalbeni, Andrea
Ciccarese, Chiara
Bevilacqua, Michele
Benati, Marco
Caimmi, Cristian
Cerrito, Luca
Famà, Federico
Iacovelli, Roberto
Mantovani, Anna
Meneguzzi, Francesco Massari Alessandra
Minuz, Pietro
Montagnana, Martina
Orsolini, Giovanni
Rossini, Maurizio
Tortora, Gianpaolo
Viapiana, Ombretta
Fava, Cristiano
Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title_full Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title_fullStr Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title_full_unstemmed Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title_short Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
title_sort effects of antiangiogenetic drugs on microcirculation and macrocirculation in patients with advanced-stage renal cancer
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357121/
https://www.ncbi.nlm.nih.gov/pubmed/30597890
http://dx.doi.org/10.3390/cancers11010030
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