Renin‑angiotensin system inhibitors may have an advantage over calcium channel blockers in reducing proteinuria in gastric cancer patients receiving ramucirumab

Chiba,Takeshi; Ujiie,Haruki; Yaegashi,Yukiko; Umehara,Kengo; Takada,Shinya; Otaki,Koichi; Sako,Ken-Ichi; Nakamaru,Yuta; Meada,Tomoji; Kudo,Kenzo; Tasaki,Yoshikazu; Sato,Hideki

doi:10.3892/br.2022.1559

Renin‑angiotensin system inhibitors may have an advantage over calcium channel blockers in reducing proteinuria in gastric cancer patients receiving ramucirumab

Authors:
- Takeshi Chiba
- Haruki Ujiie
- Yukiko Yaegashi
- Kengo Umehara
- Shinya Takada
- Koichi Otaki
- Ken-Ichi Sako
- Yuta Nakamaru
- Tomoji Meada
- Kenzo Kudo
- Yoshikazu Tasaki
- Hideki Sato
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Affiliations: Department of Clinical Pharmaceutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo‑shi, Hokkaido 006‑8585, Japan, Division of Integrated Information for Pharmaceutical Sciences, Department of Clinical Pharmacy, Iwate Medical University Hospital, Shiwa‑gun, Iwate 028‑3694, Japan, Department of Pharmacy, Iwate Medical University Hospital, Shiwa‑gun, Iwate 028‑3694, Japan, Department of Pharmacy, National Hospital Organization Hokkaido Cancer Center, Sapporo‑shi, Hokkaido 003‑0804, Japan, Department of Pharmacotherapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University of Science, Sapporo‑shi, Hokkaido 006‑8585, Japan, Department of Clinical Pharmacology and Pharmaceutics, Nihon Pharmaceutical University, Kitaadachi‑gun, Saitama 362‑0862, Japan, Department of Pharmacy, Asahikawa Medical University Hospital, Asahikawa‑shi, Hokkaido 078‑8510, Japan
Published online on: July 26, 2022 https://doi.org/10.3892/br.2022.1559
Article Number: 76
Copyright: © Chiba et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

This study aimed to investigate whether renin-angiotensin system inhibitors (RAS‑I) have an advantage over calcium channel blockers (CCB) for suppression of proteinuria in hypertensive patients with gastric cancer receiving ramucirumab (RAM) treatment. Adult Japanese patients with gastric cancer who were outpatients at Asahikawa Medical University Hospital, National Hospital Organization Hokkaido Cancer Center, and Iwate Medical University Hospital between July 1, 2015, and March 31, 2021, were included in this study. Of these patients, those who had received first‑time RAM treatment, and those treated with antihypertensive agents including RAS‑I or a CCB at initial RAM administration were included. A total of 36 patients were analyzed in this study. Of these patients, 17 patients were classified into the RAS‑I group and the remaining 19 into the CCB group. After 12 weeks of RAM administration, the prevalence of proteinuria in the RAS‑I group was significantly lower than that in the CCB group. Additionally, Kaplan‑Meier analysis showed that the cumulative occurrence of proteinuria in the RAS‑I group over 12 weeks following RAM administration was significantly lower than that in the CCB group. Furthermore, simulation of the time course of RAM blood concentrations based on the O'Brien model showed that there may not be differences in the RAM blood concentration profiles over 12 weeks between the two groups. RAS‑I may have an advantage over CCB for suppressing proteinuria in hypertensive patients with gastric cancer treated with blood pressure antihypertensive agents. Our results provide useful information to healthcare professionals involved in the administration of RAM treatment.

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