Hypertension management in patients with renal cell cancer treated with anti-angiogenic agents

P. Larochelle, C. Kollmannsberger, R. D. Feldman, E. L. Schiffrin, L. Poirier, F. Patenaude, D. Ruether, M. Myers, G. Bjarnason

Abstract


Inhibitors of the vascular endothelial growth factor (VEGF-IS) signalling pathway have fundamentally changed the treatment of metastatic renal cell carcinoma (MRCC). Hypertension is one of the most common side effects of VEGF-IS and has been reported with almost every VEGF-I used for treatment to date. The exact mechanism of VEGF-I–induced hypertension appears complex and multifactorial, and it remains to be fully explained. No randomized clinical trials are available to guide the management of hypertension during VEGF-I treatment in MRCC patients. The guiding principles suggested here summarize the consensus of opinions on the diagnosis and management of VEGF-I–induced hypertension during treatment of MRCC obtained from an expert working group composed of 4 Canadian medical oncologists and 5 Canadian hypertension specialists. The Canadian Hypertension Education Program guidelines, available literature, and expert opinion were used to develop the guiding principles.


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DOI: http://dx.doi.org/10.3747/co.19.972






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ISSN: 1198-0052 (Print) ISSN: 1718-7729 (Online)