Proteinuria risk in cancer tied to chemotherapy cycles, use of calcium channel blockers

The number of chemotherapy cycles and the use of calcium channel blockers predict the development of proteinuria related to angiogenesis inhibitors in cancer patients, a recent study has found.

Researchers enrolled 124 cancer patients undergoing chemotherapy with aflibercept, ramucirumab or bevacizumab. Proteinuria was assessed using the National Cancer Institute Common Terminology Criteria for Adverse Events. Potential predictors were extracted from clinical records and included performance status, cancer type, vital signs, medications and chemotherapy variables, among others.

Multivariate ordered logistic regression analysis found that the number of treatment cycles significantly predicted the risk of developing proteinuria (odds ratio [OR], 1.049. 95 percent confidence interval [CI], 1.018–1.082; p=0.0019).

A similar effect was reported for the use of calcium channel blockers (OR, 2.589, 95 percent CI, 1.090–6.146; p=0.0311) and systolic blood pressure (SBP; OR, 1.031, 95 percent CI, 1.005–1.058; p=0.0197).

The final resultant model was able to accurately assign a proteinuria risk value to 82 of 124 cancer patients. Receiver operating characteristic curve analysis showed that at ≥13 cycles the sensitivity and specificity of the model for determining at least grade 2 proteinuria was 63.3 percent and 72.3 percent, respectively, with a corresponding area under the curve (AUC) of 0.66.

The threshold for SBP was ≥135 mm Hg (sensitivity, 48.3 percent; specificity, 79.8 percent; AUC, 0.64). For the use of calcium channel blockers, the sensitivity and specificity values were 43.3 percent and 80.9 percent, respectively, with an AUC of 0.62.