Fiala Ondřej, Ostašov Pavel, Rozsypalová Aneta, Hora Milan, Šorejs Ondřej, Šustr Jan, Bendová Barbora, Trávníček Ivan, Filipovský Jan, Fínek Jindřich, Büchler Tomáš
Department of Oncology and Radiotherapy, Faculty of Medicine and University Hospital in Pilsen, Charles University, alej Svobody 80, 304 60, Pilsen, Czech Republic.
Laboratory of Cancer Treatment and Tissue Regeneration, Faculty of Medicine in Pilsen, Biomedical Center, Charles University, alej Svobody 76, Pilsen, Czech Republic.
Target Oncol. 2021 Sep;16(5):643-652. doi: 10.1007/s11523-021-00829-y. Epub 2021 Aug 7.
Patients with metastatic renal cell carcinoma (mRCC) are often elderly and have various comorbidities, including cardiovascular diseases. Although these patients have extensive co-exposure to targeted therapy and cardiovascular drugs, the impact of this co-exposure on outcomes for patients with mRCC remains unclear.
Our objective was to evaluate the association between the use of cardiovascular medication and survival of patients with mRCC.
The study included 343 consecutive patients with mRCC treated with sunitinib or pazopanib in the first line. Clinical data obtained from the Renal Cell Carcinoma Information System (RENIS) clinical registry and hospital information systems were retrospectively analyzed. Progression-free survival (PFS) and overall survival (OS) were compared according to the use of common medications, including antihypertensives (i.e., β-blockers [BBs], angiotensin-converting enzyme inhibitors, angiotensin II receptor blockers, calcium channel blockers, and diuretics), acetylsalicylic acid (aspirin), statins, and proton pump inhibitors.
The univariate Cox analysis evaluating the impact of the assessed comedications on patient survival revealed that only BBs were significantly associated with PFS (hazard ratio [HR] 0.533, p < 0.001) and OS (HR 0.641, p = 0.006). The median PFS and OS for users of BBs was 18.39 and 37.60 months versus 8.16 and 20.4 months for patients not using BBs (p < 0.001 and p < 0.001, respectively). The Cox multivariate analysis showed that the use of BBs was a significant factor for both PFS (HR 0.428, p = 0.001) and OS (HR 0.518, p = 0.001).
The results of this retrospective study suggest that the use of BBs is associated with favorable outcomes for patients with mRCC treated with sunitinib or pazopanib in the first line.
转移性肾细胞癌（mRCC）患者通常为老年人，且患有多种合并症，包括心血管疾病。尽管这些患者同时广泛接触靶向治疗药物和心血管药物，但这种共同接触对mRCC患者预后的影响仍不明确。
我们的目的是评估心血管药物的使用与mRCC患者生存之间的关联。
该研究纳入了343例一线接受舒尼替尼或帕唑帕尼治疗的连续性mRCC患者。对从肾细胞癌信息系统（RENIS）临床登记处和医院信息系统获得的临床数据进行回顾性分析。根据常用药物的使用情况比较无进展生存期（PFS）和总生存期（OS），这些常用药物包括抗高血压药（即β受体阻滞剂[BBs]、血管紧张素转换酶抑制剂、血管紧张素II受体阻滞剂、钙通道阻滞剂和利尿剂）、乙酰水杨酸（阿司匹林）、他汀类药物和质子泵抑制剂。
评估所使用的合并药物对患者生存影响的单变量Cox分析显示，只有BBs与PFS（风险比[HR]0.533，p<0.001）和OS（HR 0.641，p=0.006）显著相关。使用BBs患者的中位PFS和OS分别为18.39个月和37.60个月，而未使用BBs的患者分别为8.16个月和20.4个月（分别为p<0.001和p<0.001）。Cox多变量分析表明，使用BBs是PFS（HR 0.428，p=0.001）和OS（HR 0.518，p=0.001）的显著影响因素。
这项回顾性研究的结果表明，对于一线接受舒尼替尼或帕唑帕尼治疗的mRCC患者，使用BBs与良好的预后相关。
