Axitinib Induces and Aggravates Hypertension Regardless of Prior Treatment With Tyrosine Kinase Inhibitors

Hiroshi Kadowaki; Junichi Ishida; Hiroshi Akazawa; Hiroki Yagi; Akiko Saga-Kamo; Masahiko Umei; Ryo Matsuoka; Qing Liu; Hiroshi Matsunaga; Hisataka Maki; Yusuke Sato; Haruki Kume; Issei Komuro

doi:10.1253/circrep.CR-21-0008

Hypertension and Circulatory Control

Axitinib Induces and Aggravates Hypertension Regardless of Prior Treatment With Tyrosine Kinase Inhibitors

Hiroshi Kadowaki, Junichi Ishida, Hiroshi Akazawa, Hiroki Yagi, Akiko Saga-Kamo, Masahiko Umei, Ryo Matsuoka, Qing Liu, Hiroshi Matsunaga, Hisataka Maki, Yusuke Sato, Haruki Kume, Issei Komuro

Author information

Hiroshi Kadowaki
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Junichi Ishida
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Hiroshi Akazawa
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Hiroki Yagi
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Akiko Saga-Kamo
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Masahiko Umei
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Ryo Matsuoka
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Qing Liu
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Hiroshi Matsunaga
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Hisataka Maki
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]
Yusuke Sato
Department of Urology, Graduate School of Medicine, The University of Tokyo [Japan]
Haruki Kume
Department of Urology, Graduate School of Medicine, The University of Tokyo [Japan]
Issei Komuro
Department of Cardiovascular Medicine, Graduate School of Medicine, The University of Tokyo [Japan]

Keywords: Axitinib, Hypertension, Renal cell carcinoma, Tyrosine kinase inhibitor, Vascular endothelial growth factor receptor

JOURNAL OPEN ACCESS FULL-TEXT HTML

2021 Volume 3 Issue 4 Pages 234-240

DOI https://doi.org/10.1253/circrep.CR-21-0008

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Abstract

Background:Axitinib is a tyrosine kinase inhibitor (TKI) that inhibits vascular endothelial growth factor receptor signaling and is approved for second-line treatment of advanced renal cell carcinoma (RCC). Although the occurrence of hypertension with axitinib use has been documented, it is unclear whether a first-line TKI regimen can significantly affect the development of hypertension when axitinib is used as second-line therapy.

Methods and Results:In this single-center retrospective study, advanced RCC patients treated with axitinib after first-line chemotherapy were divided into 2 groups according to the use of TKIs as part of first-line treatment before the initiation of axitinib. Clinical outcomes were compared between patients who were treated with (TKI(+); n=11) or without (TKI(–); n=11) a TKI. Although 63.6% of all patients had hypertension at baseline, axitinib-induced hypertension developed in 81.8% of patients, and 36.4% of patients experienced Grade 3 hypertension. After initiation of axitinib, both systolic and diastolic blood pressures and the hypertension grade were significantly elevated both in the TKI(+) and TKI(–) groups, and the number of antihypertensive drugs was significantly increased among all patients.

Conclusions:This study suggests the need for proper monitoring and management of blood pressure in RCC patients treated with axitinib, regardless of a prior regimen with or without TKIs.

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