Treatment of arterial hypertension (AHT) associated with angiogenesis inhibitors

Abstract

A 51-year old man was diagnosed in June 2006 with bone and lung metastases of a renal clear cell carcinoma (RCC). He underwent a nephrectomy in July 2004 for a pT3pN1M0 tumour. He was enrolled in a phase II study with an oral anti-VEGF-R2 antagonist (GW786034). Fourteen days after the start of treatment, his initially normal blood pressure increased and he was treated with a calcium channel blocker (amlopidine up to 20 mg /day) and afterwards with the addition of an angiotensin converting enzyme (ACE) inhibitor (Table 1). In spite of these antihypertensive agents, his blood pressure continued to increase up to 190/120 mmHg by day 28. He remained asymptomatic and physical examination was unremarkable. He was shown to have a normal serum urea and creatinine, a urine sample tested negative for protein. An ECG and chest X-ray were also normal.