Risk factor analysis for regorafenib-induced severe hypertension in metastatic colorectal cancer treatment

Saito, Yoshitaka; Takekuma, Yoh; Komatsu, Yoshito; Sugawara, Mitsuru

Risk factor analysis for regorafenib-induced severe hypertension in metastatic colorectal cancer treatment

Saito, Yoshitaka; Takekuma, Yoh; Komatsu, Yoshito et al.

Supportive care in cancer, 2022, 30, 10203-10211

Permalink : https://hdl.handle.net/2115/90656

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論文情報

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アクセス権	open access
URI	https://hdl.handle.net/2115/90656
タイトル	Risk factor analysis for regorafenib-induced severe hypertension in metastatic colorectal cancer treatment
著者	Saito, Yoshitaka ; Takekuma, Yoh ; Komatsu, Yoshito ; Sugawara, Mitsuru
e-Rad_Researcher 00835001 著者名 Saito, Yoshitaka
e-Rad_Researcher 00396293 著者名 Takekuma, Yoh
e-Rad_Researcher 60333598 著者名 Komatsu, Yoshito
e-Rad_Researcher 60332467 著者名 Sugawara, Mitsuru
言語	英語
キーワード	Regorafenib
	Hypertension
	Vascular endothelial growth factor (VEGF)
	Pre-existing hypertension
	Risk factor
	Cardiovascular toxicity
発行日	2022-10-11
出版者	Springer
収録物名	Supportive care in cancer
巻(号)	30
ページ	10203-10211
抄録	Regorafenib, a multikinase inhibitor, is effective in treating metastatic colorectal cancer (mCRC). Hypertension is a frequently occurring adverse effect caused by regorafenib regardless of previous treatment with vascular endothelial growth factor (VEGF) inhibitors in almost all patients. We identified the risk factors associated with regorafenib-induced severe hypertension. Patients with mCRC (n = 100) who received regorafenib were evaluated retrospectively. The primary endpoint was the evaluation of the risk factors for grade >= 3 hypertension. The association between pre-existing hypertension at baseline and grade >= 3 hypertension symptoms was also assessed. Patients with pre-existing hypertension at baseline accounted for 55% of the total patients. The starting doses of regorafenib were 160 mg (49.0% of patients), 120 mg (29.0%), and 80 mg (22.0%). The incidence of grade >= 3 hypertension was 30.0%. The median time to grade >= 3 symptom development was 7 days (range: 1-56 days). Additional antihypertensive treatment was administered to 83.6% of patients who developed hypertension. Logistic regression analyses revealed that baseline pre-existing hypertension complications and previous anti-VEGF treatment for >= 700 days were independent risk factors for grade >= 3 hypertension development. Further analyses revealed that pre-existing hypertension before anti-VEGF treatment (primary hypertension) was significantly related to the symptom development (adjusted odds ratio, 8.74; 95% confidence interval, 2.86-26.72; P = 0.0001). Our study suggests that pre-existing primary hypertension and previous anti-VEGF treatment for >= 700 days are independent risk factors for regorafenib-induced severe hypertension. Deeper understanding of the symptom nature and management can significantly contribute to safer interventions, necessitating further studies.
資源タイプ	学術雑誌論文
出版タイプ	Accepted Manuscript
権利情報	This version of the article has been accepted for publication, after peer review (when applicable) and is subject to Springer Nature’s AM terms of use, but is not the Version of Record and does not reflect post-acceptance improvements, or any corrections. The Version of Record is available online at: http://dx.doi.org/10.1007/s00520-022-07381-z
PISSN	0941-4355
関連情報 (isVersionOf)	出版社版DOI https://doi.org/10.1007/s00520-022-07381-z