The antineoplastic drug sunitinib (Sutent) can cause hypertension in patients with advanced renal cell carcinoma. In a small study, French researchers reported that sunitinib and similar drugs can increase blood pressure (BP) by 15% to 25%. These findings are consistent with those of another recent study that found sunitinib raised BP and increased heart failure risk in patients with gastrointestinal stromal tumors. Sunitinib inhibits multiple receptor tyronsine kinases, some of which are implicated in tumor growth, pathologic angiogenesis, and metastatic progression of cancer.

The French study followed 14 patients with advanced renal cell carcinoma who received sunitinib at 50 mg/day for 4 weeks, followed by 2 weeks without treatment. Patients monitored their heart rate and BP at home with a validated semiautomatic electronic device and transmitted the values weekly to clinicians. Within 4 to 7 days of starting treatment, patients experienced significant increases in both systolic and diastolic BP. Seven patients who were initially normotensive became hypertensive by week four of treatment. Blood pressure readings decreased within 2 weeks of stopping treatment, but became even more markedly elevated during a second treatment cycle.

Researchers say clinicians should anticipate rapid and large increases in BP in patients treated with sunitinib and prepare to monitor and manage hypertension as indicated.

Source: Azizi M, et al., Home blood-pressure monitoring in patients receiving sunitinib, The New England Journal of Medicine, January 3, 2008.