Risk of Cardiovascular Events Higher After Antiangiogenic Therapy for RCC in Persons Older Than 65 Years

the Oncology Nurse Advisor take:

An analysis of data from the Surveillance, Epidemiology, and End Results–Medicare database has found that sunitinib and sorafenib may be associated with an increased risk of cardiovascular events, particularly stroke, in older patients with renal cell carcinoma (RCC).

Sorafenib and sunitinib are oral vascular endothelial growth factor receptor (VEGFR) tyrosine kinase inhibitors (TKIs) approved for the treatment of RCC.

The population-based, observational cohort study analyzed patients ages 66 years or older with RCC diagnosed between 2000 and 2009. The researchers examined incidence of cardiovascular events, including congestive heart failure and cardiomyopathy (CHF/CM), acute myocardial infarction (AMI), stroke, and cardiovascular deaths through December 2010.

Of the 670 patients who received sorafenib or sunitinib, 171 had experienced a cardiovascular event. Use of either of the drugs was associated with an increased risk of cardiovascular events and especially stroke compared with 788 patients with advanced RCC diagnosed from 2007 to 2009 who did not receive either agent.

Subgroup analyses revealed that patients ages 66 to 74 years at diagnosis had the highest increased risk of stroke associated with use of sorafenib or sunitinib, or both.