Risk Factors for Severe Hypertension and Proteinuria After Treatment With Vascular Endothelial Growth Factor Signaling Pathway Inhibitors Among Patients With Cancer
Paul Hanna, Rajesh Anumolu, Shveta S. Motwani, Kevin L. Chen, Nurit Katz‐Agranov, Olivia Green‐Lingren, Osman A Yilmam, Kenar D. Jhaveri, Abhijat Kitchlu, Jaya Kala, Meghan E. Sise, Shruti Gupta
Abstract
Vascular endothelial growth factor signaling pathway inhibitors (VSPIs) treat numerous types of cancers by blocking tumor angiogenesis;1 however, they are associated with both hypertension and proteinuria. Hypertension has been reported in 20% to 90% of patients.2,3 The onset of hypertension can vary from hours to weeks, depending upon the half-life of the VSPI.4 Proposed mechanisms for VSPI-associated hypertension include reduced vasodilatory nitric oxide and prostacyclin, increased peripheral vascular resistance due to increased vasoconstrictive endothelin-1, and development of renal-limited thrombotic microangiopathy.