文摘
Inhibitors of the vascular endothelial growth factor (VEGF) pathway frequently induce hypertension when used to treat patients with advanced renal cell carcinoma (RCC). This analysis characterizes hypertension and hypertension-related events in patients treated with the VEGF pathway inhibitors axitinib or sorafenib in the AXIS trial. AXIS was a randomized phase III study of axitinib versus sorafenib in patients with metastatic RCC following failure of one prior systemic regimen. Patients with uncontrolled hypertension were excluded, but patients with hypertension controlled with antihypertensive medication were allowed to participate. Guidelines for hypertension management included adjustment or addition of antihypertensive medications and/or axitinib or sorafenib dose reductions, interruptions, or discontinuations. Treatment-emergent all-causality hypertension occurred in 145 (40.4?%) axitinib-treated patients (N--59) and 103 (29.0?%) sorafenib-treated patients (N--55), with grade 3 hypertension reported in 55 (15.3?%) and 38 (10.7?%) patients, respectively, and grade 4 hypertension reported in one (0.3?%) patient in each arm. Hypertension-related events led to axitinib dose interruptions (n--6; 12.8?%), dose reductions (n--6; 4.5?%), or discontinuations (n--; 0.3?%). Approximately 50?% of axitinib-treated patients with grade 3 or 4 hypertension continued treatment for ?9?months. Hypertension-related sequelae occurred in