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Antiproteinuric effects of renin–angiotensin inhibitors in lung cancer patients receiving bevacizumab

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Abstract

Purpose

The objective of this study was to investigate the effect of renin–angiotensin system inhibitors (RASIs) on bevacizumab (BV)-induced proteinuria in non-small cell lung cancer (NSCLC) patients.

Materials and methods

We retrospectively reviewed the medical records of NSCLC patients receiving BV between 2008 and 2014 at 11 hospitals. The patients were categorized into three groups according to their antihypertensive drug use: RASI user, non-RASI user, and non-user groups. The primary outcome was a proteinuria event of any grade during the first 6 cycles of BV treatment.

Results

A total of 211 patients were included, 89 of whom received antihypertensive drugs. Of these 89 patients, 49 were in the RASI user group, and 40 were in the non-RASI user group. The non-user group comprised 122 patients. The occurrence of proteinuria in the RASI user group was significantly lower than that in the non-RASI user group (P = 0.037) but was not significantly lower than that in the non-user group (P = 0.287). Patients using RASIs had a lower rate of proteinuria than those who did not use RASIs according to multivariate analysis (odds ratio 0.32; 95% confidence interval 0.12–0.86; P = 0.024).

Conclusion

Our study suggests that RASI administration reduces the risk of proteinuria in patients receiving BV.

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Acknowledgements

This research study received no specific grant from any funding agency in the public, commercial, or not-for-profit sector. The following principal investigators and institutions contributed to the study: Y. Mori (Iwate Prefectural Central Hospital), H. Yokouchi (Fukushima Medical University Hospital), K. Taima (Hirosaki University Hospital), M. Maemondo (Miyagi Cancer Center), and H. Watanabe (Saka General Hospital).

Author information

Authors and Affiliations

  1. Division of Clinical Pharmaceutics and Pharmacy Practice, Department of Clinical Pharmacy, Iwate Medical University, School of Pharmacy, 2-1-1, Nishitokuta, Yahaba-cho, Shiwa-gun, 028-3694, Japan

    Satoru Nihei, Takeshi Chiba & Kenzo Kudo

  2. Department of Pharmacy, Shizuoka Cancer Center, 1007 Shimon agakubo, Nagaizumi-cho, Sunto-gun, 411-8777, Shizuoka Prefecture, Japan

    Junya Sato

  3. Center for Respiratory Disease, Japan Community Health Care Organization Hokkaido Hospital, 1-8-3-18, Nakanoshima, Toyohira-ku, Sapporo, 062-8618, Japan

    Toshiyuki Harada

  4. Department of Respiratory Medicine, National Hospital Organization Iwakuni Medical Center, 1-1-1, Atago-machi, Iwakuni, 740-8510, Japan

    Shoichi Kuyama

  5. Department of Internal Medicine, Iwate Prefectural Isawa Hospital, 61, Ryugababa, Mizusawa-ku, Oshu, 023-0864, Japan

    Toshiro Suzuki

  6. Department of Pharmacy, Iwate Prefectural Isawa Hospital, 61, Ryugababa, Mizusawa-ku, Oshu, 023-0864, Japan

    Nobutsugu Waga

  7. Department of Pharmacy, Hokkaido University Hospital, North 14, West 5, Kita-ku, Sapporo, 060-8648, Japan

    Yoshitaka Saito

  8. Department of Pharmacy, Tohoku University Hospital, 1-1, Seiryo-cho, Aoba-ku, Sendai, 980-8574, Japan

    Shigeki Kisara

  9. Department of Pharmacy, Fukushima Medical University Hospital, 1, Hikarigaoka, Fukushima, 960-1247, Japan

    Atsuko Yokota

  10. Department of Clinical Pharmaceutics and Pharmacy Practice, Tohoku Medical and Pharmaceutical University, 1-12-1, Fukumuro, Miyagino, Sendai, Miyagi, 983-8512, Japan

    Kouji Okada

  11. Department of Pharmacy, Miyagi Cancer Center, 47-1, Nodayama, Medeshima-Shiote, Natori, 981-1293, Japan

    Masami Tsuchiya

  12. Department of Pharmacy, Hirosaki University Hospital, 53, Hon-cho, Hirosaki, Hirosaki, 036-8563, Japan

    Kazufumi Terui

  13. Department of Pharmacy, Saka General Hospital, 16-5, Nishiki-cho, Shiogama, 985-8506, Japan

    Yumiko Tadokoro

  14. Department of Respiratory Medicine, National Hospital Organization Hokkaido Cancer, 3-54 Kikusui 4-2 Shiroishi-ku, Sapporo, Hokkaido, 003-0804, Japan

    Satoshi Oizumi

  15. Department of Palliative Medicine, Tohoku University School of Medicine, 2-1, Seiryo-cho, Aoba-ku, Sendai, 980-8575, Japan

    Akira Inoue

  16. Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal Medicine, Iwate Medical University School of Medicine, 19-1, Uchimaru, Morioka, Iwate, 020-8505, Japan

    Naoto Morikawa

Authors
  1. Satoru Nihei
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  2. Junya Sato
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  3. Toshiyuki Harada
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  4. Shoichi Kuyama
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  5. Toshiro Suzuki
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  6. Nobutsugu Waga
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  7. Yoshitaka Saito
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  8. Shigeki Kisara
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  9. Atsuko Yokota
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  10. Kouji Okada
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  11. Masami Tsuchiya
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  12. Kazufumi Terui
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  13. Yumiko Tadokoro
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  14. Takeshi Chiba
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  15. Kenzo Kudo
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  16. Satoshi Oizumi
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  17. Akira Inoue
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  18. Naoto Morikawa
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Corresponding author

Correspondence to Naoto Morikawa.

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This study was approved by the institutional review board of each participating institution and was conducted according to institutional and ethical rules concerning research on tissue specimens and patients.

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Nihei, S., Sato, J., Harada, T. et al. Antiproteinuric effects of renin–angiotensin inhibitors in lung cancer patients receiving bevacizumab. Cancer Chemother Pharmacol 81, 1051–1059 (2018). https://doi.org/10.1007/s00280-018-3580-1

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