Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study)
Abstract Background Monitoring proteinuria is important for the management of patients with cancer treated with anti-vascular endothelial growth factor (VEGF) or anti-VEGF receptor (VEGFR) inhibitors (VEGF/Ri). Here we investigated the difference between the urine protein/creatinine ratio (UPCR) and...
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| Format: | Article |
| Language: | English |
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BMC
2022-05-01
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| Series: | BMC Cancer |
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| Online Access: | https://doi.org/10.1186/s12885-022-09611-3 |
| _version_ | 1811308215870160896 |
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| author | Michio Nakamura Taro Funakoshi Shigeki Kataoka Takahiro Horimatsu Yoshitaka Nishikawa Takeshi Matsubara Takuro Mizukami Tomoyuki Goto Kenji Tsuchihashi Eishi Baba Takehiko Tsumura Yoshiaki Mihara Tetsuya Hamaguchi Motoko Yanagita Manabu Muto |
| author_facet | Michio Nakamura Taro Funakoshi Shigeki Kataoka Takahiro Horimatsu Yoshitaka Nishikawa Takeshi Matsubara Takuro Mizukami Tomoyuki Goto Kenji Tsuchihashi Eishi Baba Takehiko Tsumura Yoshiaki Mihara Tetsuya Hamaguchi Motoko Yanagita Manabu Muto |
| author_sort | Michio Nakamura |
| collection | DOAJ |
| description | Abstract Background Monitoring proteinuria is important for the management of patients with cancer treated with anti-vascular endothelial growth factor (VEGF) or anti-VEGF receptor (VEGFR) inhibitors (VEGF/Ri). Here we investigated the difference between the urine protein/creatinine ratio (UPCR) and a qualitative value test (QV) on the decision making of treatment continuation and the usefulness of UPCR testing in patients with gastrointestinal cancer treated with anti-VEGF/Ri. Methods From January 2017 to December 2018, a survey was conducted based on the medical records of patients with gastrointestinal cancer with a QV of ≥2+ during the use of anti-VEGF/Ri at seven Japanese institutions participating in the Onco-nephrology Consortium. The primary endpoint was the ratio of the worst UPCR < 2.0 (low UPCR) in cases with a QV2+ at the point of the first proteinuria onset. The secondary endpoints were a comparison of low UPCR and worst UPCR ≥2.0 (high UPCR), the concordance rate between UPCR and QV in the Common Terminology Criteria for Adverse Events (CTCAE) grading, and the differences in the decision making for anti-VEGF/Ri continuation. Results Among the 71 patients enrolled, the proportion of low UPCR in onset QV2+ (n = 53) was 66% (n = 35). In a comparison between low (n = 36) and high UPCR cases (n = 24), body weight (P = 0.036), onset QV status (P = 0.0134), and worst QV status (P < 0.0001) were significantly associated with UPCR levels. The concordance rate for CTCAE Grade 2 of both the QV and UPCR was 83%. Regarding the judgment of anti-VEGF/Ri continuation, treatment was continued in 42.4% of cases when the QV became 3+, whereas only 25% continued treatment when the UPCR value became high. Conclusion Urine dipstick test results may overestimate proteinuria, and the UPCR result tended to be more critical than the QV when deciding the treatment policy. Trial registration This study is a multiple institutional retrospectively registered observational trial. Clinical Trial number: University Hospital Medical Information Network (UMIN) Clinical Trials Registry (protocol ID UMIN000042545 ). |
| first_indexed | 2024-04-13T09:18:10Z |
| format | Article |
| id | doaj.art-c037f1bcec82452fbc6674c8c1730fe3 |
| institution | Directory Open Access Journal |
| issn | 1471-2407 |
| language | English |
| last_indexed | 2024-04-13T09:18:10Z |
| publishDate | 2022-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cancer |
| spelling | doaj.art-c037f1bcec82452fbc6674c8c1730fe32022-12-22T02:52:41ZengBMCBMC Cancer1471-24072022-05-0122111010.1186/s12885-022-09611-3Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study)Michio Nakamura0Taro Funakoshi1Shigeki Kataoka2Takahiro Horimatsu3Yoshitaka Nishikawa4Takeshi Matsubara5Takuro Mizukami6Tomoyuki Goto7Kenji Tsuchihashi8Eishi Baba9Takehiko Tsumura10Yoshiaki Mihara11Tetsuya Hamaguchi12Motoko Yanagita13Manabu Muto14Department of Gastroenterology, Sapporo City General HospitalDepartment of Clinical Oncology, Kyoto University HospitalDepartment of Clinical Oncology, Kyoto University HospitalDepartment of Clinical Oncology, Kyoto University HospitalDepartment of Health Informatics, Kyoto University School of Public HealthDepartment of Nephrology, Graduate School of Medicine, Kyoto UniversityDepartment of Clinical Oncology, St. Marianna University School of MedicineDepartment of Gastroenterology, Shiga General HospitalDepartment of Hematology, Oncology & Cardiovascular Medicine, Kyushu University HospitalDepartment of Oncology and Social Medicine, Graduate School of Medical Sciences, Kyushu UniversityDepartment of Medical Oncology, Osaka Red Cross HospitalDepartment of Medical Oncology, Saitama Medical University International Medical CenterDepartment of Medical Oncology, Saitama Medical University International Medical CenterDepartment of Nephrology, Graduate School of Medicine, Kyoto UniversityDepartment of Clinical Oncology, Kyoto University HospitalAbstract Background Monitoring proteinuria is important for the management of patients with cancer treated with anti-vascular endothelial growth factor (VEGF) or anti-VEGF receptor (VEGFR) inhibitors (VEGF/Ri). Here we investigated the difference between the urine protein/creatinine ratio (UPCR) and a qualitative value test (QV) on the decision making of treatment continuation and the usefulness of UPCR testing in patients with gastrointestinal cancer treated with anti-VEGF/Ri. Methods From January 2017 to December 2018, a survey was conducted based on the medical records of patients with gastrointestinal cancer with a QV of ≥2+ during the use of anti-VEGF/Ri at seven Japanese institutions participating in the Onco-nephrology Consortium. The primary endpoint was the ratio of the worst UPCR < 2.0 (low UPCR) in cases with a QV2+ at the point of the first proteinuria onset. The secondary endpoints were a comparison of low UPCR and worst UPCR ≥2.0 (high UPCR), the concordance rate between UPCR and QV in the Common Terminology Criteria for Adverse Events (CTCAE) grading, and the differences in the decision making for anti-VEGF/Ri continuation. Results Among the 71 patients enrolled, the proportion of low UPCR in onset QV2+ (n = 53) was 66% (n = 35). In a comparison between low (n = 36) and high UPCR cases (n = 24), body weight (P = 0.036), onset QV status (P = 0.0134), and worst QV status (P < 0.0001) were significantly associated with UPCR levels. The concordance rate for CTCAE Grade 2 of both the QV and UPCR was 83%. Regarding the judgment of anti-VEGF/Ri continuation, treatment was continued in 42.4% of cases when the QV became 3+, whereas only 25% continued treatment when the UPCR value became high. Conclusion Urine dipstick test results may overestimate proteinuria, and the UPCR result tended to be more critical than the QV when deciding the treatment policy. Trial registration This study is a multiple institutional retrospectively registered observational trial. Clinical Trial number: University Hospital Medical Information Network (UMIN) Clinical Trials Registry (protocol ID UMIN000042545 ).https://doi.org/10.1186/s12885-022-09611-3Anti-vascular endothelial growth factor therapyGastrointestinal cancerProteinuriaUrine protein/creatinine ratio |
| spellingShingle | Michio Nakamura Taro Funakoshi Shigeki Kataoka Takahiro Horimatsu Yoshitaka Nishikawa Takeshi Matsubara Takuro Mizukami Tomoyuki Goto Kenji Tsuchihashi Eishi Baba Takehiko Tsumura Yoshiaki Mihara Tetsuya Hamaguchi Motoko Yanagita Manabu Muto Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) BMC Cancer Anti-vascular endothelial growth factor therapy Gastrointestinal cancer Proteinuria Urine protein/creatinine ratio |
| title | Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) |
| title_full | Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) |
| title_fullStr | Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) |
| title_full_unstemmed | Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) |
| title_short | Decision making for anti-VEGF inhibitor continuation: dip stick? or urine protein/creatinine ratio? (VERSiON UP study) |
| title_sort | decision making for anti vegf inhibitor continuation dip stick or urine protein creatinine ratio version up study |
| topic | Anti-vascular endothelial growth factor therapy Gastrointestinal cancer Proteinuria Urine protein/creatinine ratio |
| url | https://doi.org/10.1186/s12885-022-09611-3 |
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