Navigation Links
Monitoring and control can limit side effects of promising cancer drugs
Date:5/11/2010

A new class of cancer drugs can be used effectively while minimizing hypertensive side effects if patients' blood pressure is closely monitored and controlled, a clinical panel has determined.

The panel brought oncologists, cardiologists and hypertension experts together to draft new recommendations for physicians prescribing angiogenesis inhibitors for the treatment of cancer. First approved in the mid-2000's, these drugs disrupt tumor growth by preventing the formation of new blood vessels, but also increase blood pressure in most patients.

Treating a patient's hypertension before starting the inhibitors and closely monitoring their blood pressure in the days after treatment begins can help physicians control this side effect, the panel concluded this month in the Journal of the National Cancer Institute. Those precautions may allow patients at higher risk for cardiovascular disease to benefit from these novel cancer treatments, authors said.

"This paper should impact practice today," said Michael Maitland, MD, PhD, assistant professor of medicine at the University of Chicago Medical Center and lead author on the commentary. "It should make things safer on average for patients, and will give physicians important guidance."

Several different angiogenesis inhibitors have been studied in clinical trials, and all cause an elevation of blood pressure in most patients. These drugs are also given with increased frequency to patients above 60 years old, a population with a high chance of pre-existing hypertension.

"Often the case is those patients aren't seeking medical attention for hypertension until they find that they have a tumor and need treatment for cancer," Maitland said. "If a patient is hypertensive, a physician should not dismiss that as irrelevant just because they have advanced cancer. We already know that ignoring co-morbidities in a cancer patient can generate as much risk for their long term survival as the stage of the cancer."

The panel recommended that a patient should be thoroughly screened before treatment with angiogenesis inhibitors. A risk assessment should be performed, similar to the cardiovascular assessment given patients before major surgery, Maitland said. Before treatment begins, blood pressure in high-risk patients should be reduced and maintained at less than140/90 mmHg, or even lower in patients with diabetes or chronic kidney disease.

A variety of antihypertensive drug classes can be used to lower a patient's blood pressure before or during treatment with angiogenesis inhibitors, but physicians should be aware of potential adverse interactions between the two drugs. Oncologists faced with complex cases of blood pressure management should consult colleagues more experienced in cardiology and hypertension, the panel advised.

"The recommendations put all of us on the same page," said George Bakris, MD, director of the Hypertensive Diseases Unit at the Medical Center and another author on the JNCI commentary. "It really is a seminal effort to provide some kind of general guidance and understanding of how these drugs work, what to do about their consequences, and how to successfully manage patients to make sure the outcome is ideal across the board."

Improved monitoring and treatment of hypertension during angiogenesis inhibitor treatment may open up the treatment to patients considered to be at high-risk for the side effect due to a history of cardiovascular disease or predisposition toward high blood pressure.

"We're not trying to keep anybody from getting these drugs, but there should be different levels of intensity and attention to the potential side effects based on what we know about hypertension and cardiovascular disease," Maitland said.

Further research is also underway to determine the mechanism of how angiogenesis inhibitors promote hypertension, studies that could further improve clinical management of the drugs' side effects.

"Those studies are not going to change therapy, but based on what they find, they may be able to perfect therapy and make it better," Bakris said. "This drug class has great potential for altering the natural history of many cancers. With this guidance, all physicians involved in the care of a cancer patient will be aware of monitoring blood pressure and signs of kidney injury and will know what to do if such problems arise."

"If carefully managed, I think these drugs are a huge move forward in our armory against cancer," Bakris said.

The commentary, "Initial assessment, surveillance, and management of blood pressure in patients receiving vascular endothelial growth factor signaling pathway inhibitors," appears in the May 5th issue of the Journal of the National Cancer Institute.


'/>"/>

Contact: Robert Mitchum
robert.mitchum@uchospitals.edu
773-702-6241
University of Chicago Medical Center
Source:Eurekalert

Related medicine news :

1. Cost Savings from Mobile Health Monitoring to Reach $1.9 billion to $5.8 Billion Globally by 2014 says Juniper Research
2. New Diagnostic Testing Company, Blue Ocean Biomedical, Specializes In Automated, Load & Go Cell Analysis Systems For Immune Monitoring
3. Envisat monitoring changes in oil spill
4. New VKernel AppVIEW 1.0 for Monitoring and Identification of Capacity Bottlenecks in Critical Application VMs
5. CWRU study examines effectiveness of telemonitoring vital signs
6. Revenues from Mobile Health Monitoring to Reach $1.9 Billion Globally by 2014 Says Juniper Research
7. Six Degrees Launches ePulse - an Online Buzz Monitoring Tool
8. IESO, one of the Independent System Operators in North America, Selects MetricStream GRC for Monitoring Compliance to Electric Reliability Standards
9. Improved patient care with telemonitoring
10. The Results Are In: Users of BodyMedia's Wearable Body-Monitoring Technology Lose 3 Times More Weight
11. ANT+ and iTMP Announce the Digifit™ Ecosystem - The First iPhone™ Apps to Integrate Running, Cycling and Heart Rate Monitoring
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:3/28/2017)... ... 2017 , ... “A Prophets Bones”: a thrilling adventure that reveals the mystery of Kevin’s purpose. ... that his parents and teachers had asked of him that he had neglected to do, ... defy the Almighty Creator. There were some who would have felt themselves to be special ...
(Date:3/27/2017)... ... March 27, 2017 , ... The respected dental team at ... teeth without the extensive time commitment and aesthetic disadvantages of traditional braces can ... A custom-designed series of virtually invisible aligners are created for each patient and ...
(Date:3/27/2017)... White Plains, NY (PRWEB) , ... March 27, 2017 , ... ... honoring Root Canal Awareness Week by teaching their patients about the key role this ... canal therapy from an experienced endodontist. To better serve those who need a ...
(Date:3/27/2017)... Austin, TX (PRWEB) , ... March 27, 2017 , ... ... , Edward Buckingham MD, and his colleague, Sudeep Roy, MD, was recently published ... on Bipolar Electrocautery Efficacy in Rhytidectomy” details Drs. Buckingham and Roy’s study on the ...
(Date:3/27/2017)... (PRWEB) , ... March 27, 2017 , ... ... the organization behind the New England Journal of Medicine and NEJM Journal Watch, ... Knowledge+ Pediatrics Board Review was created by a panel of pediatricians from leading ...
Breaking Medicine News(10 mins):
(Date:3/27/2017)... Inc. , a privately held, clinical-stage biopharmaceutical company developing immunogene therapeutics, ... Operating Officer, is scheduled to present a corporate overview at two ... BioPartnering & Investment Forum: Tuesday, March 28, 2017 at 3:00 PM ... ... Leaders in Biotech Industry – Friday, April 7, 2017 at 11:20 ...
(Date:3/27/2017)... -- Invivotek, LLC, a Genesis Biotechnology Group ® ... contract research organization (CRO), announced the completion of the ... research facility in Hamilton, New Jersey ... source to reduce costs and lessen the CRO facility,s ... Farm follows Invivotek,s recent expansion from a 19,712 square ...
(Date:3/24/2017)... 24, 2017 Abdominal Aortic Aneurysm Repair Devices Market was valued at ... registering a CAGR of 5.1% from 2016 to 2022. The endovascular stent graft system ... market during the study period. Continue Reading ... ... ...
Breaking Medicine Technology: