Heart failure associated with RCC treatment

Sunitinib malate (Sutent), indicated for the treatment of metastatic renal cell carcinoma, may be associated with heart failure in less than 3% of patients receiving the drug, according to a study published in Cancer (2008; 112:2500-8). The finding may represent a potentially serious toxicity and may underscore the need for careful monitoring of cardiac function and aggressive control of hypertension in these patients.

Researchers at the University of Texas M. D. Anderson Cancer Center, Houston, conducted a retrospective study during a 1-year period on patients receiving sunitinib who later developed heart failure. In 2006, six of 224 (2.7%) patients who received sunitinib developed heart failure that resulted in substantial morbidity and, in some cases, mortality.

Symptomatic heart failure occurred soon after initiation of the drug (mean onset, 22 days after initiation), was associated with decline in cardiac function and elevations in blood pressure, and was not completely reversible in most patients, even after termination of sunitinib therapy.

The authors said further studies to elucidate potential mechanisms of heart failure and left ventricular dysfunction resulting from treatment with sunitinib are recommended.