Older kidney cancer patients treated with sorafenib or sunitinib may face an increased risk of cardiovascular adverse events, according to a study published in Cancer.

Sekwon Jang, M.D., from the Inova Dwight and Martha Schar Cancer Institute in Fairfax, Virginia, and colleagues used the Surveillance, Epidemiology, and End Results-Medicare database to identify patients who were 66 years or older and were diagnosed with renal cell carcinoma (RCC) from 2000 to 2009. The incidence of cardiovascular adverse events was analyzed through December 2010.

The researchers found that 171 of 670 patients who received sunitinib or sorafenib had cardiovascular events. The incidence rates for congestive heart failure and cardiomyopathy, acute myocardial infarction, and stroke were 0.87, 0.14, and 0.14 per 1,000 person-days, respectively.

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There was an increased risk of cardiovascular events associated with sunitinib or sorafenib use (hazard ratio [HR], 1.38), especially for stroke (HR, 2.84), compared with the 788 patients diagnosed with advanced RCC from 2007 to 2009 who were eligible but did not receive either drug. Patients aged 66 to 74 years at diagnosis had the highest increased risk of stroke associated with use of the drugs.

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“Sunitinib and sorafenib might be associated with an increased risk of cardiovascular events and particularly stroke,” conclude the authors.

Two authors report financial ties to the pharmaceutical industry.


  1. Jang S, Zheng C, Tsai H, et al. Cardiovascular toxicity after antiangiogenic therapy in persons older than 65 years with advanced renal cell carcinoma. Cancer. [published online ahead of print October 6, 2015]. DOI: 10.1002/cncr.29728.