%0 Journal Article
%T Effects of Antiangiogenetic Drugs on Microcirculation and Macrocirculation in Patients with Advanced-Stage Renal Cancer
%A Andrea Dalbeni
%A Anna Mantovani
%A Chiara Ciccarese
%A Cristian Caimmi
%A Cristiano Fava
%A Federico Fam¨¤
%A Francesco Massari Alessandra Meneguzzi
%A Gianpaolo Tortora
%A Giovanni Orsolini
%A Luca Cerrito
%A Marco Benati
%A Martina Montagnana
%A Maurizio Rossini
%A Michele Bevilacqua
%A Ombretta Viapiana
%A Pietro Minuz
%A Roberto Iacovelli
%J Archive of "Cancers".
%D 2019
%R 10.3390/cancers11010030
%X Adverse cardiovascular effects, including hypertension, were described in patients with different cancers treated with tyrosine kinase inhibitors (TKI). The mechanism of TKI-related hypertension is still debated. The aim of this work was to study the effects of TKI on blood pressure (BP), searching for a relationship with possible causative factors in patients with metastatic renal cell carcinoma. We included 29 patients in a prospective, observational study; 22 were treated with a first-line drug (sunitinib), while seven participated in the second-line treatment (axitinib or cabozantinib). Patients were investigated at the beginning of antiangiogenic therapy (T0) and at one (T1), three (T2), and six months (T3) after treatment. Patients were evaluated by office blood pressure (BP) and ultrasonography to measure flow-mediated dilatation (FMD), and carotid artery distensibility (cDC) by echocardiography and nailfold capillaroscopy. Plasma endothelin-1 (p-ET-1), urine nitrates, and proteins were also measured. At T1, systolic BP, along with U proteins and p-ET-1, increased significantly. In patients with a clinically significant increase in BP (defined as either the need for an antihypertensive drug or systolic blood pressure (SBP) T1¨CT0 ¡Ý10 and/or SBP ¡Ý140 mmHg and/or diastolic blood pressure (DBP) T1¨CT0 ¡Ý5 and/or DBP ¡Ý90 mmHg), the urine nitrate concentration was lower at T0, whereas there were no differences in the p-ET-1 and U proteins. Seventeen participants showed changes in the capillaroscopic pattern at T1 with no association with BP increases. There were no differences in the FMD, cDC, and echocardiographic parameters. Our findings are consistent with those of previous studies about BP increases by TKI, and suggest a role of nitric oxide in BP maintenance in this population
%K TKI
%K angiogenesis
%K VEGF
%K renal cancer
%K NO (Nitric Oxide)
%K endothelin-1
%K capillaroscopy
%K hypertension
%U https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6357121/