Abstract
16097 Background: Tyrosine-kinase inhibitors (TKI), have significant clinical activity in patients (pts) with RCC. Cardiotoxicity is relatively common toxicity of these molecules. Schmidinger et al (ASCO, 2007) have detected preclinical and clinical stage of myocardial damage in more than 20% of patients treated with TKIs. ECG-changes and biochemical markers are the most important indicators of this damage. HRECG is promising method for early identification of patients at risk of anthracycline cardiotoxicity. The aim of this prospective observational study was to investigate the value of HRECG in combination with biochemical markers in identification myocardial damage in preclinical stage in pts undergoing TKI-treatment for RCC. Methods: Eighteen consecutive patients (5F/13M; median age 63, range 47–75) intended for TKI treatment were analyzed for medical history of coronary artery disease (CAD) and risk-factors. Time- and frequency-domain analyses of HRECG, biochemical markers of cardiac damage (cardiac troponin T -cTNT, pro brain natriuretic peptide- proBNP-) and echocardiography were performed before and 12 weeks after begining of treatment. Results: Twelve patients were treated with sunitinib and 6 patients with sorafenib. All patients had normal pro-BNP and TNT at baseline. Median follow-up was 6 months (range: 3–8 months). During this period, we didn´t observed clinical or laboratory signs of myocardial damage. Mean values of proBNP and cTNT were 401 pg/ mL and 0.01 ng/mL before therapy and 406 pg/mL and 0.01 ng/mL after 12 weeks of therapy (p = 0.96). The HRECG had not shown any signs of myocardial damage. Conclusions: In presented study the number of events of myocardial damage was lower than was expected. However, based on our results, it seems that normal HRECG before and after 12 weeks of therapy could be a usefull marker for selection of patients with low risk of cardiotoxicity induced by sunitinib and sorafenib. Longer follow-up is needed. Updated clinical results will be presented. No significant financial relationships to disclose.
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