Urine protein:creatinine ratio vs 24-hour urine protein for proteinuria management: analysis from the phase 3 REFLECT study of lenvatinib vs sorafenib in hepatocellular carcinoma

Evans, T. R. J. et al. (2019) Urine protein:creatinine ratio vs 24-hour urine protein for proteinuria management: analysis from the phase 3 REFLECT study of lenvatinib vs sorafenib in hepatocellular carcinoma. British Journal of Cancer, 121(3), pp. 218-221. (doi: 10.1038/s41416-019-0506-6) (PMID:31249394) (PMCID:PMC6738107)

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Abstract

Background: Proteinuria monitoring is required in patients receiving lenvatinib, however, current methodology involves burdensome overnight urine collection. Methods: To determine whether the simpler urine protein:creatinine ratio (UPCR) calculated from spot urine samples could be accurately used for proteinuria monitoring in patients receiving lenvatinib, we evaluated the correlation between UPCR and 24-hour urine protein results from the phase 3 REFLECT study. Paired data (323 tests, 154 patients) were analysed. Results: Regression analysis showed a statistically significant correlation between UPCR and 24-hour urine protein (R2: 0.75; P < 2 × 10−16). A UPCR cut-off value of 2.4 had 96.9% sensitivity, 82.5% specificity for delineating between grade 2 and 3 proteinuria. Using this UPCR cut-off value to determine the need for further testing could reduce the need for 24-hour urine collection in ~74% of patients. Conclusion: Incorporation of UPCR into the current algorithm for proteinuria management can enable optimisation of lenvatinib treatment, while minimising patient inconvenience.

Item Type:Articles
Additional Information:This study was funded by Eisai Inc., Woodcliff Lake, NJ, and Merck Sharp and Dohme Corp., a subsidiary of Merck and Co., Inc., Kenilworth, NJ, USA.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Evans, Professor Jeff
Authors: Evans, T. R. J., Kudo, M., Finn, R. S., Han, K.-H., Cheng, A.-L., Ikeda, M., Kraljevic, S., Ren, M., Ductus, C. E., Piscaglia, F., and Sung, M. W.
College/School:College of Medical Veterinary and Life Sciences > School of Cancer Sciences
Journal Name:British Journal of Cancer
Publisher:Springer Nature
ISSN:0007-0920
ISSN (Online):1532-1827
Published Online:28 June 2019
Copyright Holders:Copyright © 2019 The Authors
First Published:First published in British Journal of Cancer 121:218-221
Publisher Policy:Reproduced under a Creative Commons License

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