Patients with metastatic renal cell carcinoma (mRCC) are often elderly and have various comorbidities, including cardiovascular diseases. Although these patients have extensive co-exposure to targeted therapy and cardiovascular drugs, the impact of this co-exposure on outcomes for patients with mRCC remains unclear.
Our objective was to evaluate the association between the use of cardiovascular medication and survival of patients with mRCC.
The study included 343 consecutive patients with mRCC treated with sunitinib or pazopanib in the first line. Clinical data obtained from the Renal Cell Carcinoma Information System (RENIS) clinical registry and hospital information systems were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were compared according to the use of common medications, including antihypertensives (i.e., β-blockers [BBs], angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and diuretics), acetylsalicylic acid (aspirin), statins, and proton pump inhibitors.
The univariate Cox analysis evaluating the impact of the assessed comedications on patient survival revealed that only BBs were significantly associated with PFS (hazard ratio [HR] 0.533, p < 0.001) and OS (HR 0.641, p = 0.006). The median PFS and OS for users of BBs was 18.39 and 37.60 months versus 8.16 and 20.4 months for patients not using BBs (p < 0.001 and p < 0.001, respectively). The Cox multivariate analysis showed that the use of BBs was a significant factor for both PFS (HR 0.428, p = 0.001) and OS (HR 0.518, p = 0.001).
The results of this retrospective study suggest that the use of BBs is associated with favorable outcomes for patients with mRCC treated with sunitinib or pazopanib in the first line.
Targeted oncology. 2021 Aug 07 [Epub ahead of print]
Ondřej Fiala, Pavel Ostašov, Aneta Rozsypalová, Milan Hora, Ondřej Šorejs, Jan Šustr, Barbora Bendová, Ivan Trávníček, Jan Filipovský, Jindřich Fínek, Tomáš Büchler
Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University, alej Svobody 80, 304 60, Pilsen, Czech Republic. ., Laboratory of Tumor Biology and Immunotherapy, Faculty of Medicine in Pilsen, Biomedical Center, Charles University, alej Svobody 76, Pilsen, Czech Republic., Department of Oncology, First Faculty of Medicine, Charles University and Thomayer Hospital, Videnska 800, Prague, Czech Republic., Department of Urology, Faculty of Medicine and University Hospital in Pilsen, Charles University, E. Beneše 13, Pilsen, Czech Republic., Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University, alej Svobody 80, 304 60, Pilsen, Czech Republic., 2nd Department of Internal Medicine, Faculty of Medicine and University Hospital in Pilsen, Charles University, E. Beneše 13, Pilsen, Czech Republic.