1
|
Ishihara H, Nemoto Y, Tachibana H, Ikeda T, Fukuda H, Yoshida K, Kobayashi H, Iizuka J, Shimmura H, Hashimoto Y, Kondo T, Takagi T. Association Between Kidney Function and Outcomes Following Immune Checkpoint Inhibitor-Based Combination Therapy in Patients With Advanced Renal Cell Carcinoma. Clin Genitourin Cancer 2024; 22:549-557.e5. [PMID: 38281878 DOI: 10.1016/j.clgc.2024.01.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND It remains unclear whether kidney function affects outcomes following immune checkpoint inhibitor (ICI)-based combination therapy for advanced renal cell carcinoma (RCC). METHODS We retrospectively evaluated data of 167 patients with advanced RCC, including 98 who received ICI dual combination therapy (ie, immunotherapy [IO]-IO) and 69 who received ICI combined with tyrosine kinase inhibitor (TKI) (ie, IO-TKI). In each regimen, treatment profiles were assessed according to the grade of chronic kidney disease (CKD) as defined by the KDIGO 2012 criteria. RESULTS Of the 98 patients who received IO-IO, 31 (32%), 30 (31%), 15 (15%), and 22 (22%) had CKD G1/2, G3a, G3b, and G4/5, respectively. Of the 69 patients who received IO-TKI, 18 (26%), 25 (36%), and 26 (38%) had G1/2, G3a, and G3b/4/5, respectively. Regarding efficacy, progression-free survival, overall survival, or objective response rate was not different according to the CKD grade in both treatment groups (P > .05). Regarding safety, the rate of adverse events, treatment interruption, or corticosteroid administration was not different according to the CKD grade in the IO-IO group (P > .05), whereas in the IO-TKI group, the incidence of grade ≥ 3 adverse events were significantly higher (P = .0292), and the rates of ICI interruption (P = .0353) and corticosteroid administration (P = .0685) increased, according to the CKD grade. CONCLUSION There is a differential safety but comparable efficacy profile between the IO-IO and IO-TKI regimens in patients with CKD. Further prospective studies are required to confirm these findings.
Collapse
Affiliation(s)
- Hiroki Ishihara
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
| | - Yuki Nemoto
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan; Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan; Department of Urology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan
| | | | - Takashi Ikeda
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hironori Fukuda
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Kazuhiko Yoshida
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | - Hirohito Kobayashi
- Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan
| | - Junpei Iizuka
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| | | | - Yasunobu Hashimoto
- Department of Urology, Saiseikai Kawaguchi General Hospital, Kawaguchi, Saitama, Japan
| | - Tsunenori Kondo
- Department of Urology, Tokyo Women's Medical University Adachi Medical Center, Adachi-ku, Tokyo, Japan
| | - Toshio Takagi
- Department of Urology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan
| |
Collapse
|
2
|
Abraham S, Samson A. Case report: Successful treatment of a patient undergoing haemodialysis with multifocal hepatocellular carcinoma using atezolizumab and bevacizumab. Front Oncol 2024; 13:1279501. [PMID: 38239658 PMCID: PMC10794777 DOI: 10.3389/fonc.2023.1279501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 11/09/2023] [Indexed: 01/22/2024] Open
Abstract
In the last five years, the advent of combination immune checkpoint inhibitor atezolizumab and anti-angiogenic agent bevacizumab has transformed treatment of unresectable hepatocellular carcinoma. As patient outcomes improve, healthcare professionals will more frequently encounter patients with concomitant hepatocellular cancer and end stage kidney disease on haemodialysis. We present the first case in the literature of a 58-year-old male with multifocal hepatocellular carcinoma undertaking regular haemodialysis who was successfully treated with atezolizumab and bevacizumab with a partial response and stable disease for two years, who suffered grade 1 fatigue, grade 2 hypertension and eventually grade 3 wound infection leading to cessation of bevacizumab. After disease progression on atezolizumab monotherapy, all chemotherapy was stopped. We embed this case in a review of the current literature of atezolizumab and bevacizumab use in patients undertaking haemodialysis and conclude that both targeted therapies may be safely used in these patients. We recommend joint close management of these patients between oncology and nephrology teams, with initial cardiovascular risk stratification before commencing atezolizumab and bevacizumab therapy. During therapy, there should be regular monitoring of blood pressure, or proteinuria if the patient is oliguric under guidance of the dialysis team if preservation of residual renal function is required.
Collapse
Affiliation(s)
| | - Adel Samson
- Leeds Cancer Centre, Leeds Teaching Hospitals National Health Service (NHS) Trust, Leeds, United Kingdom
| |
Collapse
|
3
|
Yang C, Yang F, Chen X, Li Y, Hu X, Guo J, Yao J. Overexpression of complement C5a indicates poor survival and therapeutic response in metastatic renal cell carcinoma. Int J Biol Markers 2023:3936155231161366. [PMID: 36883235 DOI: 10.1177/03936155231161366] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
INTRODUCTION Complement C5a is an important component of the innate immune system. An increasing number of reports have revealed the relevance of C5a in tumor progression; however, its exact role in metastatic renal cell carcinoma (mRCC) remains unknown. METHODS We evaluated C5a expression in tumor tissue microarrays of 231 mRCC patients and analyzed the relationship between C5a levels and clinical outcomes, and the expression of epithelial-mesenchymal transition (EMT)-related proteins, programmed cell death protein 1 (PD-1), and programmed cell death-ligand 1 (PD-L1). In-vitro functional experiments using exogenous C5a stimulation and C5a silencing in renal cell carcinoma cells were used to validate the tissue findings. RESULTS High C5a expression was associated with poor therapeutic responses, poor overall and progression-free survival, and high expression of EMT-related proteins and PD-1/PD-L1 in mRCC patients. Exogenous C5a promoted proliferation, migration, and invasion of renal cell carcinoma cells, and induced the expression of EMT-related proteins and PD-1/PD-L1. Conversely, C5a silencing inhibited migration and invasion of renal cell carcinoma cells and decreased the expression of EMT-related proteins and PD-1/PD-L1. CONCLUSIONS Our findings indicate that elevated C5a expression is associated with poor outcomes in patients with mRCC, and this effect may be partly attributed to the ability of C5a to promote EMT and PD-1/PD-L1 expression. C5a may be a potential novel target for the treatment of mRCC.
Collapse
Affiliation(s)
- Changjun Yang
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Gansu, China.,Institute of Urology, 74786Hexi University, Zhangye Gansu, China
| | - Faying Yang
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Gansu, China.,Institute of Urology, 74786Hexi University, Zhangye Gansu, China
| | - Xiang Chen
- Department of Urology, Zhongshan Hospital, 12478Fudan University, Shanghai, China
| | - Yunpeng Li
- Department of Urology, Zhongshan Hospital, 12478Fudan University, Shanghai, China
| | - Xiaoyi Hu
- Department of Urology, Zhongshan Hospital, 12478Fudan University, Shanghai, China
| | - Jianming Guo
- Department of Urology, Zhongshan Hospital, 12478Fudan University, Shanghai, China
| | - Jiaxi Yao
- Department of Urology, Hexi University Affiliated Zhangye People's Hospital, Gansu, China.,Institute of Urology, 74786Hexi University, Zhangye Gansu, China
| |
Collapse
|
4
|
Katsumata Y, Kawasaki Y, Tanaka K, Nakayama D, Katayama H, Shimada S, Satake Y, Sato T, Kawamorita N, Yamashita S, Sato T, Shoji K, Mitsuzuka K, Ito A. Combination Therapy of Pembrolizumab plus Axitinib for a Patient on Hemodialysis with Metastatic Renal Cell Carcinoma: A Case Report. Case Rep Oncol 2021; 14:1522-1529. [PMID: 34899246 PMCID: PMC8613611 DOI: 10.1159/000519855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Accepted: 09/23/2021] [Indexed: 11/24/2022] Open
Abstract
Here, we discuss the safety and management of adverse events associated with pembrolizumab plus axitinib combination therapy for metastatic renal cell carcinoma in patients on hemodialysis. A 76-year-old man was diagnosed with cT3aN0M0 renal cell carcinoma due to gross hematuria. Stereoscopic radiotherapy for metastatic lesions of the ipsilateral kidney was performed 9 years after right laparoscopic radical nephrectomy. Soon after, the patient started to receive hemodialysis due to end-stage renal disease. Further stereoscopic radiotherapy was needed for metastasis of the ipsilateral kidney and lung. Fifteen years after diagnosis, systemic therapy was necessary to control new metastases, such as in the right scapular bone. We selected pembrolizumab plus axitinib combination therapy as the first-line systemic therapy for any risk as defined by the International Metastatic RCC Database Consortium. Although we needed to pay attention to the adverse events unique to hemodialysis, he underwent this combination therapy without any difficulty for 6 months. Here, we report the practice of combination therapy in patients on hemodialysis in light of the literature.
Collapse
Affiliation(s)
- Yuki Katsumata
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Yoshihide Kawasaki
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | | | | | - Hiromichi Katayama
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Shuichi Shimada
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Yohei Satake
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Takuma Sato
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Naoki Kawamorita
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Shinichi Yamashita
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Testuya Sato
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Kosuke Shoji
- Division of Emergency and Critical Care Medicine, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Koji Mitsuzuka
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| | - Akihiro Ito
- Department of Urology, Tohoku University Graduate School of Medicine, Tohoku, Japan
| |
Collapse
|
5
|
Mielczarek Ł, Brodziak A, Sobczuk P, Kawecki M, Cudnoch-Jędrzejewska A, Czarnecka AM. Renal toxicity of targeted therapies for renal cell carcinoma in patients with normal and impaired kidney function. Cancer Chemother Pharmacol 2021; 87:723-742. [PMID: 33768301 PMCID: PMC8110505 DOI: 10.1007/s00280-021-04260-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/13/2021] [Indexed: 12/11/2022]
Abstract
The introduction of novel targeted therapies during the last 2 decades has led to a significant improvement in patients' clinical outcomes with renal cell carcinoma. However, this improvement came at the price of a whole new spectrum of adverse events, including renal toxicity. Systemic treatment of patients with kidney neoplasms who often present with impairment of kidney function, even prior to treatment, poses an increasing diagnostic and therapeutic challenge for clinicians. Common lifestyle-related comorbidities, i.e., hypertension and diabetes, may contribute to further impairment of kidney function. The lack of official guidelines and the exclusion of patients with reduced kidney function from the clinical trials of recently approved drugs complicate the issue even further. Early detection and correct management of renal toxic effects are crucial to preserve kidney function and ensure the optimal administration of life-prolonging therapies. This review presents detailed information on the renal toxicities of three groups of drugs commonly used in renal cell carcinoma treatment: tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, and immune checkpoint inhibitors. We outline the incidence and underlying mechanisms of renal adverse effects with a focus on patients on renal replacement therapy, as well as present suggestions for their management.
Collapse
Affiliation(s)
- Łukasz Mielczarek
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Anna Brodziak
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Paweł Sobczuk
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Maciej Kawecki
- Department of Oncology and Radiotherapy, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Agnieszka Cudnoch-Jędrzejewska
- Department of Experimental and Clinical Physiology, Laboratory of Centre for Preclinical Research, Medical University of Warsaw, Warsaw, Poland
| | - Anna M Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland.
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre Polish Academy of Sciences, Warsaw, Poland.
| |
Collapse
|
6
|
Wang XR, Wang S, Li WB, Xu KY, Qiao XP, Jing XL, Wang ZX, Yang CJ, Chen SW. Design, synthesis and biological evaluation of novel 2-(4-(1H-indazol-6-yl)-1H-pyrazol-1-yl)acetamide derivatives as potent VEGFR-2 inhibitors. Eur J Med Chem 2021; 213:113192. [PMID: 33493829 DOI: 10.1016/j.ejmech.2021.113192] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 12/28/2020] [Accepted: 01/10/2021] [Indexed: 12/30/2022]
Abstract
Vascular endothelial growth factor-2 (VEGFR-2) plays a pivotal role in tumor angiogenesis. Herein, a library of novel 2-(4-(1H-indazol-6-yl)-1H-pyrazol -1-yl)acetamide derivatives were designed and synthesized as VEGFR-2 inhibitors based on scaffold hopping strategy. These compounds exhibited the excellent inhibitory in both VEGFR-2 and tumor cells proliferation. Especially, compound W13 possessed potent VEGFR-2 inhibition with IC50 = 1.6 nM and anti-proliferation against HGC-27 tumor cells with IC50 = 0.36 ± 0.11 μM, as well as less toxicity against normal GES-1 cells with IC50 = 187.46 ± 10.13 μM. Moreover, W13 obviously inhibited colony formation, migration and invasion of HGC-27 cells by adjusting the expression of MMP-9 and E-cadherin, and induced HGC-27 cells apoptosis by increasing ROS production and regulating the expression of apoptotic proteins. Furthermore, W13 blocked the PI3K-Akt-mTOR signaling pathway in HGC-27 cells. In addition, anti-angiogenesis of W13 was proved by inhibiting tube formation and the expression of p-VEGFR-2 in HUVEC cells. All the results demonstrated that W13 could be developing as a promising anticancer agent for gastric cancer therapy.
Collapse
Affiliation(s)
- Xing-Rong Wang
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Shuai Wang
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Wen-Bo Li
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Kai-Yan Xu
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Xue-Peng Qiao
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Xue-Li Jing
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | - Zi-Xiao Wang
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China
| | | | - Shi-Wu Chen
- School of Pharmacy, Lanzhou University, Lanzhou, 730000, China.
| |
Collapse
|
7
|
Martín-Aguilar AE, Núñez-López H, Ramirez-Sandoval JC. Sorafenib as a second-line treatment in metastatic renal cell carcinoma in Mexico: a prospective cohort study. BMC Cancer 2021; 21:16. [PMID: 33402115 PMCID: PMC7786959 DOI: 10.1186/s12885-020-07720-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 12/08/2020] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Sequential inhibition of the vascular endothelial growth factor (VEGF) pathway with sorafenib could be useful for patients with metastatic renal cell carcinoma (RCC). Our aim was to determine the activity and tolerability of sorafenib as a second-line therapy in advanced RCC initially treated with a different VEGF-tyrosine kinase inhibitor (TKI). METHODS A prospective observational cohort in Mexico (2012-2019). We included 132 subjects with metastatic RCC and who had progression despite treatment with sunitinib. The primary end-point was time to disease progression as evaluated every 12-16 weeks. RESULTS The mean age of the cohort was 59 years (interquartile range [IQR] 50-72), 96 (73%) were men, and 48 (36%) had a favorable prognosis according to the IMDC (International Metastatic RCC Database Consortium) prognostic model. The median progression-free survival (PFS) and overall-survival after the introduction of sorafenib treatment was 8.6 months (95% confidence interval [CI]: 6.7-10.5) and 40 months (95% CI: 34.5-45.4) respectively. The median overall survival from RCC diagnosis to death was 71 months (95% CI: 58.2-83.8). On multivariable analyses, age > 65 years was associated with a longer PFS (HR 0.51; 95% CI: 0.31-0.86; p = 0.018). The median PFS in subjects aged > 65 years was longer compared to subjects ≤65 years (14.0 [95% CI: 9.2-18.8] vs. 7.2 months [95% CI: 5.3-9.1]; p = 0.012). Adverse events grade ≥ 3 associated with sorafenib occurred in 38 (29%) patients. CONCLUSION Sequential inhibition of VEGF with sorafenib as a second-line treatment may benefit patients with metastatic RCC, especially in subjects > 65 years old.
Collapse
Affiliation(s)
- Ana Elena Martín-Aguilar
- Centro Médico Nacional Siglo XXI, Av. Cuauhtémoc 330, Doctores, Cuauhtémoc, 06720 Ciudad de México, CDMX, Mexico City, Mexico
| | - Haidé Núñez-López
- Centro Médico Nacional Siglo XXI, Av. Cuauhtémoc 330, Doctores, Cuauhtémoc, 06720 Ciudad de México, CDMX, Mexico City, Mexico
| | - Juan C Ramirez-Sandoval
- Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Belisario Dominguez Sección XVI, 14080, Mexico City, PC, Mexico.
| |
Collapse
|
8
|
Klajer E, Garnier L, Goujon M, Schlurmann-Constans F, Mery B, Nguyen Tan Hon T, Mouillet G, Calcagno F, Thiery-Vuillemin A. Targeted and immune therapies among patients with metastatic renal carcinoma undergoing hemodialysis: A systemic review. Semin Oncol 2020; 47:103-116. [PMID: 32522380 DOI: 10.1053/j.seminoncol.2020.05.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 02/06/2023]
Abstract
BACKGROUND Patients with severe renal impairment or undergoing hemodialysis are usually excluded from clinical trials. Available data regarding safety and activity of systemic therapies (ST) in hemodialyzed patients are scarce. METHODS Clinical data were searched through PubMed database until April 2020 according to PRISMA criteria. Efficacy, safety and pharmacokinetic (PK) assessment of ST were reported. RESULTS Among 270 references, 56 reports were evaluated in full text: 41 were included for efficacy and 42 for safety analysis (sunitinib n = 68, bevacizumab n = 6, everolimus n = 28, temsirolimus n = 17, sorafenib n = 55, axitinib n = 13, pazopanib n = 13, nivolumab n = 18, cabozantinib n = 0, lenvatinib n = 0, and ipilimumab n = 0). Twelve of the reports included PK assessment among dialyzed patients. Hemodialysis did not seem to modify the expected efficacy and safety of each compound among patients undergoing hemodialysis. PK assessments were not modified in comparison with a population not undergoing dialysis. CONCLUSION Targeted and Immune therapies seem to be effective and can be used among patients undergoing hemodialysis. Due to frailty and comorbidities associated to chronic hemodialysis enhanced vigilance for these therapies within this specific population is recommended. Dedicated prospective clinical trials would definitely help to obtain data with a higher level of evidence.
Collapse
Affiliation(s)
- Elodie Klajer
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France; Université de Franche-Comté, Besançon cedex, France.
| | - Louis Garnier
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France
| | - Morgan Goujon
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France
| | | | - Benoite Mery
- Department of Medical Oncology, Lucien Neuwirth Cancer Institute, St Priest en Jarez, France
| | | | - Guillaume Mouillet
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France; Methodology and Quality of Life in Oncology Unit, CHRU Jean Minjoz, Besançon cedex, France
| | - Fabien Calcagno
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France
| | - Antoine Thiery-Vuillemin
- Department of Medical Oncology, CHRU Jean Minjoz, Besançon cedex, France; Université de Franche-Comté, Besançon cedex, France; INSERM, Besançon cedex France
| |
Collapse
|
9
|
Silvestris N, Argentiero A, Cosmai L, Porta C, Gesualdo L, Brunori G, Brunetti O, Rampino T, Secondino S, Rizzo G, Pedrazzoli P. Management of targeted therapies in cancer patients with chronic kidney disease, or on haemodialysis: An Associazione Italiana di Oncologia Medica (AIOM)/Societa’ Italiana di Nefrologia (SIN) multidisciplinary consensus position paper. Crit Rev Oncol Hematol 2019; 140:39-51. [DOI: 10.1016/j.critrevonc.2019.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/27/2019] [Accepted: 05/28/2019] [Indexed: 01/06/2023] Open
|
10
|
Pucci G, Milan A, Paini A, Salvetti M, Cerasari A, Vaudo G. Acute blood pressure elevation associated with biological therapies for cancer: a focus on VEGF signaling pathway inhibitors. Expert Opin Biol Ther 2019; 19:433-442. [PMID: 30888868 DOI: 10.1080/14712598.2019.1594770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Treatment with biological agents interfering with mechanisms of angiogenesis, such as vascular endothelial growth factor (VEGF) signaling pathway (VSP) inhibitors, was associated with an enhanced risk of acute and severe blood pressure (BP) increase and development of hypertensive emergencies. Areas covered: The present article will review the scientific literature reporting hypertensive emergencies as a complication of biological treatment with VSP inhibitors. Hypertensive emergency is a life-threatening condition characterized by very high BP values (>180/110 mmHg) associated with acute organ damage. The exact mechanism of action is still incompletely clarified. Endothelial dysfunction following reduced bioavailability of nitric oxide has been hypothesized to play an important role in promoting hypertension and the occurrence of acute organ damage. Expert opinion: Prevention, prompt recognition and treatment of hypertensive emergencies associated with treatment with VSP-inhibitors are essential to reduce the risk of adverse events. Not infrequently, the occurrence of hypertensive emergency led to VSP treatment discontinuation, with potential negative consequences on patient overall survival. The present review aims at providing detailed knowledge for the clinician regarding this specific issue, which could be of high impact in usual clinical practice, given the increasing burden of indications to treatment with biological agents targeted to the VEGF pathway.
Collapse
Affiliation(s)
- Giacomo Pucci
- a Department of Medicine , University of Perugia , Perugia , Italy.,b Unit of Internal Medicine , Terni University Hospital , Terni , Italy
| | - Alberto Milan
- c Department of Medical Sciences - Hypertension Center , University of Torino - AOU Città della Salute e della Scienza di Torino , Torino , Italy
| | - Anna Paini
- d Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | - Massimo Salvetti
- d Department of Clinical and Experimental Sciences , University of Brescia , Brescia , Italy
| | - Alberto Cerasari
- a Department of Medicine , University of Perugia , Perugia , Italy.,b Unit of Internal Medicine , Terni University Hospital , Terni , Italy
| | - Gaetano Vaudo
- a Department of Medicine , University of Perugia , Perugia , Italy.,b Unit of Internal Medicine , Terni University Hospital , Terni , Italy
| |
Collapse
|
11
|
Kashihara T, Murakami N, Iizumi S, Sakamoto Y, Nakamura S, Iijima K, Takahashi K, Inaba K, Okuma K, Igaki H, Nakayama Y, Okusaka T, Uno T, Itami J. Hemorrhage from Ascending Colon and Gluteal Muscle Associated with Sorafenib and Radiation Therapy: Radiation Dose Distribution Corresponded with Colonoscopy Findings and Computed Tomography Images. Pract Radiat Oncol 2019; 9:214-219. [PMID: 30825665 DOI: 10.1016/j.prro.2019.02.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 02/11/2019] [Accepted: 02/18/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Tairo Kashihara
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan.
| | - Naoya Murakami
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Sakura Iizumi
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Yasunari Sakamoto
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Satoshi Nakamura
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Kotaro Iijima
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Kana Takahashi
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Koji Inaba
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Kae Okuma
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Hiroshi Igaki
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Yuko Nakayama
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| | - Takuji Okusaka
- Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital, Tokyo, Japan
| | - Takashi Uno
- Department of Radiology, Chiba University Hospital, Chiba, Japan
| | - Jun Itami
- Department of Radiation Therapy, National Cancer Center Hospital, Tokyo, Japan
| |
Collapse
|
12
|
Ansari J, Ali M, Farrag A, Ali AM, Alhamad A. Efficacy of Nivolumab in a Patient with Metastatic Renal Cell Carcinoma and End-Stage Renal Disease on Dialysis: Case Report and Literature Review. Case Reports Immunol 2018; 2018:1623957. [PMID: 30009063 DOI: 10.1155/2018/1623957] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2018] [Revised: 04/18/2018] [Accepted: 05/15/2018] [Indexed: 01/05/2023] Open
Abstract
Treatment of patients with metastatic renal cell carcinoma (mRCC) and end-stage renal disease (ESRD) on dialysis poses a therapeutic challenge, particularly as this patient group was excluded from the pivotal clinical trials. In addition, there is uncertainty regarding drug dosing/pharmacokinetics, lack of safety and efficacy data, and potential for increased toxicity when using targeted therapy or immunotherapy for the management of patients with mRCC on dialysis. Nivolumab, an anti-programmed death-1 immune checkpoint inhibitor antibody, is indicated for the treatment of patients with mRCC who have received prior antiangiogenic therapy. Given the above-mentioned uncertainties, clinicians may be reluctant to use nivolumab for this patient population, leading to potential denial of life-prolonging medications. We report the case of a 72-year-old gentleman with mRCC and ESRD on dialysis who received second-line nivolumab therapy and achieved an excellent symptomatic and radiological response, remaining progression-free for over 22 months. In addition, we have reviewed the pharmacokinetic data and published retrospective case studies to review the management options for patients with mRCC and ESRD on dialysis.
Collapse
|
13
|
Park JJ, Boddy AV, Liu X, Harris D, Lee V, Kefford RF, Carlino MS. Pharmacokinetics of dabrafenib in a patient with metastatic melanoma undergoing haemodialysis. Pigment Cell Melanoma Res 2017; 30:68-71. [DOI: 10.1111/pcmr.12557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2016] [Accepted: 10/26/2016] [Indexed: 10/20/2022]
Affiliation(s)
- John J. Park
- Crown Princess Mary Cancer Centre; Westmead Hospital; Westmead NSW Australia
| | | | | | - David Harris
- University of Sydney; Sydney NSW Australia
- Department of Renal Medicine; Westmead Hospital; Westmead NSW Australia
| | - Vincent Lee
- University of Sydney; Sydney NSW Australia
- Department of Renal Medicine; Westmead Hospital; Westmead NSW Australia
| | - Richard F. Kefford
- Crown Princess Mary Cancer Centre; Westmead Hospital; Westmead NSW Australia
- Department of Clinical Medicine; Macquarie University; Sydney NSW Australia
- Melanoma Institute Australia; Sydney NSW Australia
| | - Matteo S. Carlino
- Crown Princess Mary Cancer Centre; Westmead Hospital; Westmead NSW Australia
- University of Sydney; Sydney NSW Australia
- Melanoma Institute Australia; Sydney NSW Australia
| |
Collapse
|
14
|
Devisscher L, Vieri M, Logue SE, Panse J, Geerts A, van Vlierberghe H, Chevet E, Gorman AM, Samali A, Kharabi Masouleh B. Targeting the angio-proteostasis network: Combining the forces against cancer. Pharmacol Ther 2016; 167:1-12. [DOI: 10.1016/j.pharmthera.2016.07.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 07/14/2016] [Indexed: 01/24/2023]
|
15
|
Fleming BD, Ho M. Glypican-3 Targeting Immunotoxins for the Treatment of Liver Cancer. Toxins (Basel) 2016; 8:E274. [PMID: 27669301 DOI: 10.3390/toxins8100274] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 09/13/2016] [Accepted: 09/14/2016] [Indexed: 12/25/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, yet no effective therapeutics exist. This review provides an overview of the recent development of recombinant immunotoxins for the treatment of glypican-3 (GPC3) expressing HCC. GPC3 is a cell surface heparan sulfate proteoglycan that is overexpressed in HCC, but is absent from normal adult human tissues. Treatment of HCC with anti-GPC3 immunotoxins represents a new therapeutic option. Using phage display and hybridoma technologies, three high affinity antibodies (HN3, HS20 and YP7) have been generated against GPC3. Two of these antibodies (HN3 and HS20) have demonstrated the ability to inhibit Wnt/Yap signaling, leading to a reduction in liver cancer cell proliferation. By combining the HN3 antibody capable of inhibiting Wnt/Yap signaling with the protein synthesis inhibitory domain of the Pseudomonas exotoxin, a recombinant immunotoxin that exhibits a dual inhibitory mechanism was generated. This immunotoxin was found to be highly effective in the treatment of human HCCs in mouse xenograft models. Engineering of the toxin fragment to reduce the level of immunogenicity is currently being explored. The development of immunotoxins provides opportunities for novel liver cancer therapies.
Collapse
|