Both New-Onset and Pre-Existing Hypertension Indicate Favorable Clinical Outcomes in Patients Treated With Anti-Vascular Endothelial Growth Factor Therapy

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  • Moriyama Shohei
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Hieda Michinari
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Kisanuki Megumi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Kawano Shotaro
    Division of Immunology and Rheumatology, Hamanomachi Hospital
  • Yokoyama Taku
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Fukata Mitsuhiro
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Kusaba Hitoshi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital Division of Oncology, Hamanomachi Hospital
  • Maruyama Toru
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital Division of Cardiology, Haradoi Hospital
  • Baba Eishi
    Department of Oncology and Social Medicine, Kyushu University
  • Akashi Koichi
    Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
  • Fukuda Haruhisa
    Department of Health Care Administration and Management, Kyushu University

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Abstract

<p>Background: Hypertension is a frequent adverse event caused by vascular endothelial growth factor signaling pathway (VSP) inhibitors. However, the impact of hypertension on clinical outcomes during VSP inhibitor therapy remains controversial.</p><p>Methods and Results: We reviewed 3,460 cancer patients treated with VSP inhibitors from the LIFE Study database, comprising Japanese claims data between 2016 and 2020. Patients were stratified into 3 groups based on the timing of hypertension onset: (1) new-onset hypertension (n=569; hypertension developing after VSP inhibitor administration); (2) pre-existing hypertension (n=1,790); and (3) no hypertension (n=1,101). Time to treatment failure (TTF) was used as the primary endpoint as a surrogate for clinical outcomes. The median (interquartile range) TTF in the new-onset and pre-existing hypertension groups was 301 (133–567) and 170 (72–358) days, respectively, compared with 146 (70–309) days in the non-hypertensive group (P<0.001 among all groups). In an adjusted Cox proportional hazard model, new-onset (hazard ratio [HR] 0.58; 95% confidence interval [CI] 0.50–0.68; P<0.001) and pre-existing (HR 0.85; 95% CI 0.73–0.98; P=0.026) hypertension were independent factors for prolonged TTF. The TTF of new-onset hypertension was longer than that of pre-existing hypertension (HR 0.68; 95% CI 0.62–0.76; P<0.001).</p><p>Conclusions: This study highlighted that new-onset hypertension induced by VSP inhibitors was an independent factor for favorable clinical outcomes. Pre-existing hypertension before VSP inhibitor initiation was also a significant factor.</p>

Journal

  • Circulation Journal

    Circulation Journal 88 (2), 217-225, 2024-01-25

    The Japanese Circulation Society

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