Adverse events (AEs) are unexpected medical issues that arise upon treatment. Now, this is a very broad term, and it can be broken down into more specific categories depending on what part of the body they impact. For example, one category is major adverse cardiac events (MACE). These can be very dangerous, with examples like strokes or heart failure. Because of this, predicting these events is extremely helpful, as it allows doctors to target and prevent them.
Recent research published in the Journal of Clinical Oncology set out to do just this in the phase 3 JAVELIN Renal 101 trial. The research team discovered that renal cell carcinoma (RCC) patients who see a higher level of serum troponin T at baseline live at a higher risk of MACEs.
Predicting MACE in RCC
The JAVELIN Renal 101 trial was randomized and enrolled 873 patients living with advanced renal cell carcinoma. 434 of the participants received avelumab in combination with axitinib, while the other 439 were treated with sunitinib. The researchers evaluated a number of signs, including left ventricular ejection fraction (LVEF) and serum cardiac biomarkers. Upon evaluation, the following results were produced:
- High serum troponin T levels at baseline were linked with a 3x higher risk of MACE
- This association was only observed in the avelumab plus axitinib group
- 7.1% of RCC patients treated with avelumab plus axitinib experienced MACE
- Patients with high troponin T levels at baseline saw an incidence of 17.2%
- Patients with normal troponin T levels at baseline saw an incidence of 5.2%
- 3.9% of the RCC patients treated with sunitinib experienced MACE
- There was no difference in incidence based on troponin T levels at baseline
- Between both arms, there was no link between MACE and LVEF decline, hypertension, or most other cardiovascular risk factors
In the end, this information is helpful to medical professionals treating their RCC patients with any of these therapies. Specifically, those being treated with a combination of ICI and VEGFR inhibitors with high levels of troponin T at baseline should be monitored in regard to MACE. Careful monitoring could lead to prevention or early intervention, both of which improve patient outcomes.
About Renal Cell Carcinoma
RCC is a form of kidney cancer that typically begins with a single tumor in one kidney but easily spreads to the lungs and throughout the body. Symptoms often do not appear until this spread has occurred, which can impact diagnosis and intervention. They include abdominal pain, fatigue, high blood pressure, bloody or discolored urine, weight loss, fever, enlarged testicles, varicose testis vein, and vision abnormalities.
While medical professionals are unsure as to what exactly causes RCC, they do know that there are a number of risk factors. These include smoking and a history of kidney problems. Research has also linked mutations in the TFE 3, PRC, and VHL genes to this cancer. Treatment consists of removing the kidney, bladder, and any necessary surrounding tissue. Other treatment options include Proleukin, chemotherapy, sorafenib, hormone treatments, ablation, and Afinitor.
You can find the source article here.
