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

  • Satoru Nihei
  • Junya Sato
  • Toshiyuki Harada
  • Shoichi Kuyama
  • Toshiro Suzuki
  • Nobutsugu Waga
  • Yoshitaka Saito
  • Shigeki Kisara
  • Atsuko Yokota
  • Kouji Okada
  • Masami Tsuchiya
  • Kazufumi Terui
  • Yumiko Tadokoro
  • Takeshi Chiba
  • Kenzo Kudo
  • Satoshi Oizumi
  • Akira Inoue
  • Naoto Morikawa
Original Article
  • 41 Downloads

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.

Keywords

Bevacizumab Renin–angiotensin system inhibitor Non-small cell lung cancer Proteinuria 

Notes

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).

Compliance with ethical standards

Conflict of interest

The authors have declared no conflicts of interest.

Research involving human participants and/or animals

Formal consent is not required for this type of study.

Informed consent

Informed consent is not required for this type of study.

Ethical approval

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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Satoru Nihei
    • 1
  • Junya Sato
    • 2
  • Toshiyuki Harada
    • 3
  • Shoichi Kuyama
    • 4
  • Toshiro Suzuki
    • 5
  • Nobutsugu Waga
    • 6
  • Yoshitaka Saito
    • 7
  • Shigeki Kisara
    • 8
  • Atsuko Yokota
    • 9
  • Kouji Okada
    • 10
  • Masami Tsuchiya
    • 11
  • Kazufumi Terui
    • 12
  • Yumiko Tadokoro
    • 13
  • Takeshi Chiba
    • 1
  • Kenzo Kudo
    • 1
  • Satoshi Oizumi
    • 14
  • Akira Inoue
    • 15
  • Naoto Morikawa
    • 16
  1. 1.Division of Clinical Pharmaceutics and Pharmacy Practice, Department of Clinical PharmacyIwate Medical University, School of PharmacyShiwa-gunJapan
  2. 2.Department of PharmacyShizuoka Cancer CenterSunto-gunJapan
  3. 3.Center for Respiratory DiseaseJapan Community Health Care Organization Hokkaido HospitalSapporoJapan
  4. 4.Department of Respiratory MedicineNational Hospital Organization Iwakuni Medical CenterIwakuniJapan
  5. 5.Department of Internal MedicineIwate Prefectural Isawa HospitalOshuJapan
  6. 6.Department of PharmacyIwate Prefectural Isawa Hospital, 61, Ryugababa, Mizusawa-kuOshuJapan
  7. 7.Department of PharmacyHokkaido University HospitalSapporoJapan
  8. 8.Department of PharmacyTohoku University HospitalSendaiJapan
  9. 9.Department of PharmacyFukushima Medical University HospitalFukushimaJapan
  10. 10.Department of Clinical Pharmaceutics and Pharmacy PracticeTohoku Medical and Pharmaceutical UniversitySendaiJapan
  11. 11.Department of PharmacyMiyagi Cancer CenterNatoriJapan
  12. 12.Department of PharmacyHirosaki University HospitalHirosakiJapan
  13. 13.Department of PharmacySaka General HospitalShiogamaJapan
  14. 14.Department of Respiratory MedicineNational Hospital Organization Hokkaido CancerSapporoJapan
  15. 15.Department of Palliative MedicineTohoku University School of MedicineSendaiJapan
  16. 16.Division of Pulmonary Medicine, Allergy, and Rheumatology, Department of Internal MedicineIwate Medical University School of MedicineMoriokaJapan

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