New Study Shows Blood Pressure Increase Indicates Treatment Response

April 29 2011

Patients who develop high blood pressure while being treated for advanced kidney cancer with the drug sunitinib respond better to treatment, maintain longer progression-free survival, and survive longer, according to a Cleveland Clinic-led study.

The study, published today in The Journal of the National Cancer Institute, demonstrates that high blood pressure (hypertension) is a significant independent predictor of improved outcomes for patients with metastatic renal cell carcinoma.

“These findings support the hypothesis that high blood pressure may act as a biomarker of a medication’s anti-tumor effectiveness,” said Brian Rini, MD, a staff physician in Cleveland Clinic’s Taussig Cancer Institute. “What that means is that physicians may be able to monitor a patient’s blood pressure to gauge how effectively sunitinib is treating their advanced kidney cancer.”

In the retrospective study led by Dr. Rini, patients whose maximum systolic blood pressure reached 140 mmHg or greater survived nearly four times longer (30.5 months) compared to those who had lower maximum systolic pressure (7.8 months). Those whose maximum diastolic blood pressure reached 90 mmHg or greater survived twice as long (32.2 months compared to 14.9 months).

Hypertensive patients also experienced 2.5- to 5-times longer progression-free survival – the period of time during which the tumor either shrank or did not grow. Those with systolic hypertension had 12.5 months of progression-free survival compared to 2.5 months in patients without hypertension. Those with diastolic hypertension had 13.4 months of progression-free survival, compared to 5.3 months in patients without hypertension. “Most importantly, these results may give us greater insight into the biology of kidney cancer and the factors that determine a patient’s response to sunitinib and other similar drugs in order to extend the benefits to more people,” Rini said.

The majority of the 544 patients in the efficacy analysis experienced hypertension at some point during their sunitinib treatment – 81 percent had systolic hypertension (140 or higher), while 67 percent had diastolic hypertension (90 or higher).

The use of blood pressure-lowering medication did not reduce the treatment’s anti-tumor effectiveness.

Although patients with hypertension developed more kidney toxicity than patients without hypertension, hypertension-associated side effects were uncommon.

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