SAN FRANCISCO, CA USA (UroToday.com) - Dr. Vincent Launay-Vacher presented results from the MARS (Management of Antiangiogenics Renovascular Safety) study, a prospective multi-center study of renovascular tolerance of anti-VEGF drugs (AVD) in multiple different tumor types.
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The authors’ goal was to assess the prevalence of renovascular abnormalities before treatment with anti-angiogenic drugs. The incidence of hypertension (HTN) and proteinuria (PU) were assessed both prior to initiation of anti-angiogenic therapy and following treatment. Patients included were naïve of any previous AVD, and had standard indications for treatment with AVD. Demographic, oncological, and renovascular data were collected and compared.
In total, 1 124 patients were studied; 137 had RCC, and 112 were treated with sunitinib. Median age was 61 years, and visceral, bone, and brain metastases were present in 71%, 42%, and 12.5% of patients, respectively. Sunitinib was administered at usual doses. Treatment duration was > 6 or > 12 months in 70.5% and 50.8%, respectively. At baseline, HTN and PU were present in 43.8% (grade 3 in 4.5%) and 15.6%, respectively. During follow-up after treatment with sunitinib, 75.0% developed PU (4.5% grade 3), and 21.4% developed HTN (14.3% grade 3). Overall, no thrombotic micro-angiopathy was reported, indicating it remains a rare side effect of anti-VEGF therapy.
The prevalence of renovascular abnormalities in patients with mRCC prior and following initiation of sunitinib is high. Thorough evaluation of renovascular status should be performed in all patients prior to initiation of AVD therapy. Follow-up of renovascular status should be performed in all patients.
Highlights of a presentation by Vincent Launay-Vacher, MD at the 2014 Genitourinary Cancers Symposium - January 30 - February 1, 2014 - San Francisco Marriott Marquis - San Francisco, California USA
Pitie-Salpetriere Hospital, Paris France