Table 3.

Clinical characteristics of individual patients experiencing LV dysfunction while on sunitinib

PatientAge (yrs)GenderBaseline cardiac medicationsSunitinib starting dose (mg)Baseline LVEF (%)Maximum LVEF decline (%)aMaximum change in biomarker (pg/mL)bHF symptomsNew cardiac medicationsSunitinib continuedLVEF recoveryRecovery LVEF (%)Timing of LVEF recoveryNotes
155MBB, statin, diuretic5049.910.1TnI: −4.1BNP: −504Fatigue, dyspneaNoneYesN/AN/AN/AExpired from RCC prior to subsequent ECHO
243MStatin5053.417.2TnI: +227.5BNP: +3.9FatigueBB, CCBYesYes43.8Wk 33Changed RCC therapy wk 30 secondary to disease progression
356FNone5053.114.1UnkFatigue, dyspnea, PNDNoneYesYes67.6Initial recovery Wk 15; Full recovery by Wk 52SU dose reduction and changed to 2/1 schedule wk 15
441FNone5051.714.7TnI: +0.5BNP: +5.2Fatigue, ankle swellingNoneYesYes50.9Wk 33SU dose reduction and changed to 2/1 schedule wk 15
561MASA, ARB, CCB, Diuretic5047.112.0TnI: +3.8BNP: +3.8FatigueClonidineBBYesYes57.9Wk 33
666MCCB5055.012.0TnI: +0.7BNP: +23.6Fatigue, ankle swellingARB, diureticBBNoYes52.0Wk 33Changed RCC therapy wk 12 secondary to disease progression
746MNone37.553.511.5TnI: −22.4BNP: +15.6Fatigue, dyspneaACEiYesYes52.6Wk 15
845MASA5049.712.5TnI: +0.3BNP: −9.5FatigueNoneYesYes46.2Wk 33Changed to 2/1 schedule wk 15
956MBB, CCB, other5062.115.8TnI: +9.2BNP: +1726NoneNoneYesN/AN/AN/AExpired from RCC prior to subsequent ECHO
  • Abbreviations: ACEi, angiotensin-converting enzyme inhibitor; ARB, angiotensin receptor blocker; ASA, aspirin; BB, beta-blocker; CCB, calcium channel blocker; ECHO, echocardiography; HF, heart failure; N/A, not applicable; Statin, HMG CoA reductase inhibitor; SU, sunitinib; TnI, high-sensitivity cardiac troponin I; Unk, unknown; Wk, week.

  • aFor all patients with the exception of patient 4, LV dysfunction was detected at week 3.5. For patient 4, this was detected at 15 weeks.

  • bMaximum change in biomarker from baseline visit (i.e., biomarker value at follow-up visit—biomarker value at baseline visit).