Table 3.
Antihypertensive medications, blood pressure, and catecholamine metabolites (at baseline and at the time of the best blood pressure control) in six patients who experienced clinical benefit during sunitinib therapy
| Patient no. | At baseline | At 4 wk | At 2–6 months | At 8–10 months | At 12 months |
|---|---|---|---|---|---|
| 1 | |||||
| Drugs | Phenoxybenzamine, 30 mg/d; atenolol, 50 mg/d | Phenoxybenzamine, 30 mg/d; atenolol, 50 mg/d | Prazosin, 1 mg/d | Phenoxybenzamine, 30 mg/d; atenolol, 50 mg/d | Died |
| Blood pressure (mm Hg) | 95/73 | 100/60 | 99/77 | 150/80 | |
| PNM (pmol/liter) | 43,407 | 6928 | Disease progression | ||
| Normal values | <3592] | <808 | |||
| 2 | |||||
| Drugs | Terazosin 2 mg/d; carvedilol, 80 mg/d | Terazosin, 2 mg/d; ramipril, 5 mg/d; aliskiren, 300 mg/d; carvedilol, 50 mg/d; phenoxybenzamine, 20 mg twice a day | Terazosin, 2 mg/d; ramipril, 5 mg/d; aliskiren, 300 mg/d; carvedilol, 50 mg/d | No antihypertensives | No antihypertensives |
| Blood pressure (mm Hg) | 128/77 | 170/92 | 130/69 | 97/67 | 100/62 |
| PNM (pmol/liter) | 12,017 | 57,000 | |||
| Normal values | <808 | <900 | |||
| PM (pmol/liter) | 202 | 1930 | |||
| Normal values | <288 | <500 | |||
| 3 | |||||
| Drugs | Terazosin, 8 mg/d | Terazosin 10 mg/d; phenoxybenzamine 10 mg/d | Terazosin 2 mg/d | No antihypertensives | No antihypertensives |
| Blood pressure (mm Hg) | 139/87 | 165/116 | 100/69 | 93/61 | 101/64 |
| UNM (nmol/d) | 38,869 | 8703 | |||
| Normal values | <3690 | <3690 | |||
| 4 | |||||
| Drugs | Doxazosin, 2 mg/d | Doxazosin, 4 mg/d; atenolol, 50 mg/d | Doxazosin, 2 mg/d | Doxazosin, 2 mg/d | Doxazosin, 2 mg every other day |
| Blood pressure (mm Hg) | 126/69 | 107/61 | 100/67 | 109/66 | 116/67 |
| PNM (pmol/liter) | 5689 | 5443 | |||
| Normal values | <808 | <808 | |||
| 13 | |||||
| Drugs | Atenolol, 100 mg/d; irbesartan, 150 mg/d; prazosin, 20 mg/d | Celiprolol, 400 mg/d; prazosin, 20 mg/d; metyrosine, 2000 mg/d | Prazosin, 5 mg/d; amlodipine, 10 mg/d; atenolol, 100 mg/d; metyrosine, 2000 mg | Amlodipine, 10 mg/d; prazosin, 15 mg/d; metyrosine, 2000 mg/d; atenolol, 100 mg/d | Amlodipine, 10 mg/d; prazosin, 5 mg; celiprolol, 200 mg/d; metyrosine, 2000 mg |
| Blood pressure (mm Hg) | 130/80 | 161/94 | 150/80 | 120/80 | 143/92 |
| UNM (nmol/mmol creatinine) | 17,440 | 1321 | 2218 | ||
| Normal values | <275 | <275 | <275 | ||
| UM (nmol/mmol creatinine) | 5894 | 37 | 134 | ||
| Normal values | <120 | <120 | <120 | ||
| 15 | |||||
| Drugs | Prazosin, 10 mg/d; propranolol, 20 mg/d | Ramipril, 10 mg/d; metoprolol, 200 mg/d | Ramipril, 1.25 mg/d; metoprolol, 200 mg/d | Prazosin, 1 mg/d; metoprolol, 200 mg/d | Prazosin, 1 mg/d; metoprolol, 200 mg/d |
| Blood pressure (mm Hg) | 130/85 | 120/70 | 100/50 | 90/60 | 130/80 |
| UNM (nmol/mmol creatinine) | 1288 | 377 | 268 | ||
| Normal values | <275 | <275 | <275 |
Patients 5, 6, 7, 8, 16, and 17 did not experience hypertension improvement or exacerbation while taking sunitinib. Patients 9, 10, and 11 could not tolerate the drug. Patient 9 had exacerbation of hypertension; patient 10's blood pressure did not change; patient 11 developed hypotension. Patients 12 and 14 were not hypertensive and did not experience hypertension while taking sunitinib. PM, Plasma metanephrines; PNM, plasma normetanephrines; UM, urine metanephrines; UNM, urine normetanephrines.