Angiotensin-inhibitors as treatment of sunitinib/pazopanib induced hypertension in metastatic renal cell carcinoma

Abstract Background Research suggests that baseline use of angiotensin system inhibitors (ASIs) improves outcome in metastatic renal cell carcinoma (mRCC) patients, but it remains unknown, whether the type of antihypertensive medication used to initiate management at onset of treatment-induced hypertension (HTN) is associated with outcome. We evaluated the association of ASIs and outcome among mRCC patients treated with first-line tyrosine kinase inhibitors (TKIs). Patients and Methods We identified 303 consecutive mRCC patients that were treated with sunitinib or pazopanib in a single university hospital cancer center. Statistical analyses were performed using the Kaplan-Meier method and Cox regression adjusted for known risk factors. Results Progression-free survival (PFS) and overall survival (OS) were similar among patients with baseline HTN ( N=197 , 65%) vs. patients with no baseline HTN ( N=106 , 35%) (PFS; P=0.72 ) (OS; P=0.54 ). There was a significant difference between patients with treatment-induced HTN ( N=110 ) vs. patients with no treatment-induced HTN ( N=193 ) for PFS (15.6 vs. 6.4 months, respectively; P