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:6/25/2016)... ... 25, 2016 , ... The temporary closing of Bruton Memorial Library on June 21 due to ... a new, often overlooked aspect of head lice: the parasite’s ability to live away from ... common occurrence, but a necessary one in the event that lice have simply gotten out ...
(Date:6/25/2016)... ... 25, 2016 , ... On Friday, June 10, Van Mitchell, Secretary of the ... to iHire in recognition of their exemplary accomplishments in worksite health promotion. , The ... Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. iHire was one ...
(Date:6/24/2016)... ... 2016 , ... Marcy was in a crisis. Her son James, eight, was out of control. ... and physically. , “When something upset him, he couldn’t control his emotions,” remembers Marcy. ... rocks at my other children and say he was going to kill them. If ...
(Date:6/24/2016)... ... 2016 , ... Topical BioMedics, Inc, makers of Topricin and MyPainAway Pain Relief Products, join The ... raise to $12 an hour by 2020 and then adjusting it yearly to increase at ... the minimum wage, assure the wage floor does not erode again, and make future increases ...
(Date:6/24/2016)... ... June 24, 2016 , ... Strategic Capital Partners, ... economy by obtaining investment capital for emerging technology companies. SCP has delivered ... already resulted in more than a million dollars of capital investment for five ...
Breaking Medicine News(10 mins):
(Date:6/24/2016)... DUBLIN , June 24, 2016 ... and Markets has announced the addition of the ... their offering. ... products and provides an updated review, including its applications ... covering the total market, which includes three main industries: ...
(Date:6/24/2016)... , June 24, 2016  American Respiratory Labs (ARL), a ... now able to perform sophisticated lung assessments in patients, homes, thanks ... Inc. Patients are no longer limited to having ... PRO ® , ARL patients like Jeanne R. of ... the comfort of her own home. ...
(Date:6/24/2016)... Belgium , June 24, 2016 /PRNewswire/ ... announced the appointment of Dr. Edward Futcher ... a Non-Executive Director, effective June 23, 2016.Dr. Futcher ... and Nominations and Governance Committees.  As a non-executive ... provide independent expertise and strategic counsel to VolitionRx ...
Breaking Medicine Technology: