Patients given sunitinib need close monitoring for cardiac problems

December 13, 2007

Sunitinib - a tyrosine-kinase inhibitor used to extend survival in patients with renal-cell carcinoma and gastrointestinal stromal tumours - has cardiotoxic effects. As such, patients given sunitinib, especially those with cardiac risk factors - need to be closely monitored. These are the conclusions of authors of an Article published in this week's edition of The Lancet.

Dr Ming Hui Chen, Cardiology Department, Children's Hospital Boston, MA, USA, and colleagues, studied 75 adult patients with metastatic, gastrointestinal stromal tumours, which had not responded to imatinib (the standard treatment); these patients had subsequently been enrolled in a phase I/II trial investigating the efficacy of sunitinib. Cardiac death, heart attack and congestive heart failure were the endpoints of the study. The researchers also investigated the effect of sunitinib on left ventricular ejection fraction (LVEF) and blood pressure.

They found that eight of the 75 patients given repeating cycles of sunitinib had a cardiovascular event - two had heart attacks, while the other six had heart failure. Of 36 patients given the approved sunitinib dose, 10 (28%) experienced reductions in LVEF of 10% or more, while seven (19%) experienced LVEF reductions of 15% or more. Sunitinib also induced increases in mean systolic and diastolic blood pressure, with 35 of 75 patients (47%) developing hypertension. Heart failure and left ventricular dysfunction generally improved when sunitinib was withdrawn and medical management was implemented. Further, sunitinib caused mitochondrial injury and death of cardiomyocyte cells in rodents.

The authors conclude: "Our findings reveal evidence of sunitinib-associated heart failure, left ventricular systolic dysfunction, and hypertension in patients with imatinib-resistant, metastatic gastrointestinal stromal tumours. Cardiovascular adverse events were medically manageable in most patients. Close monitoring could be a prudent approach until large studies can clearly define the nature and rate of sunitinib-associated cardiovascular effects, especially in patients with cardiac risk factors, or history of coronary artery disease, or both."

In an accompanying Comment, Dr Heikki Joensuu, Helsinki University Central Hospital, Finland, says: "Patients treated with sunitinib need careful monitoring not only for hand-foot syndrome and other well-established adverse effects but also for thyroid and cardiac function. Although data are limited and more research is needed, sunitinib might be at least as cardiotoxic as trastuzumab."
The paper associated with this release is at

For Dr Ming Hui Chen, Cardiology Department, Children's Hospital Boston, MA, USA please contact Anna Gonski T) +1 617-919-3110 E)

Dr Heikki Joensuu, Helsinki University Central Hospital, Finland E)


Related Heart Failure Articles from Brightsurf:

Top Science Tip Sheet on heart failure, heart muscle cells, heart attack and atrial fibrillation results
Newly discovered pathway may have potential for treating heart failure - New research model helps predict heart muscle cells' impact on heart function after injury - New mass spectrometry approach generates libraries of glycans in human heart tissue - Understanding heart damage after heart attack and treatment may provide clues for prevention - Understanding atrial fibrillation's effects on heart cells may help find treatments - New research may lead to therapy for heart failure caused by ICI cancer medication

Machining the heart: New predictor for helping to beat chronic heart failure
Researchers from Kanazawa University have used machine learning to predict which classes of chronic heart failure patients are most likely to experience heart failure death, and which are most likely to develop an arrhythmic death or sudden cardiac death.

Heart attacks, heart failure, stroke: COVID-19's dangerous cardiovascular complications
A new guide from emergency medicine doctors details the potentially deadly cardiovascular complications COVID-19 can cause.

Autoimmunity-associated heart dilation tied to heart-failure risk in type 1 diabetes
In people with type 1 diabetes without known cardiovascular disease, the presence of autoantibodies against heart muscle proteins was associated with cardiac magnetic resonance (CMR) imaging evidence of increased volume of the left ventricle (the heart's main pumping chamber), increased muscle mass, and reduced pumping function (ejection fraction), features that are associated with higher risk of failure in the general population

Transcendental Meditation prevents abnormal enlargement of the heart, reduces chronic heart failure
A randomized controlled study recently published in the Hypertension issue of Ethnicity & Disease found the Transcendental Meditation (TM) technique helps prevent abnormal enlargement of the heart compared to health education (HE) controls.

Beta blocker use identified as hospitalization risk factor in 'stiff heart' heart failure
A new study links the use of beta-blockers to heart failure hospitalizations among those with the common 'stiff heart' heart failure subtype.

Type 2 diabetes may affect heart structure and increase complications and death among heart failure patients of Asian ethnicity
The combination of heart failure and Type 2 diabetes can lead to structural changes in the heart, poorer quality of life and increased risk of death, according to a multi-country study in Asia.

Preventive drug therapy may increase right-sided heart failure risk in patients who receive heart devices
Patients treated preemptively with drugs to reduce the risk of right-sided heart failure after heart device implantation may experience the opposite effect and develop heart failure and post-operative bleeding more often than patients not receiving the drugs.

How the enzyme lipoxygenase drives heart failure after heart attacks
Heart failure after a heart attack is a global epidemic leading to heart failure pathology.

Novel heart pump shows superior outcomes in advanced heart failure
Severely ill patients with advanced heart failure who received a novel heart pump -- the HeartMate 3 left ventricular assist device (LVAD) -- suffered significantly fewer strokes, pump-related blood clots and bleeding episodes after two years, compared with similar patients who received an older, more established pump, according to research presented at the American College of Cardiology's 68th Annual Scientific Session.

Read More: Heart Failure News and Heart Failure Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to