An Observational Study of Bevacizumab-Induced Hypertension as a Clinical Biomarker of Antitumor Activity
- Olivier Mira,b,
- Romain Coriata,
- Laure Cabanesc,
- Stanislas Roperta,
- Bertrand Billemonta,
- Jérôme Alexandrea,
- Jean-Philippe Duranda,
- Jean-Marc Treluyerb,
- Bertrand Knebelmannd and
- François Goldwassera
- aCentre for Research on Angiogenesis Inhibitors (CERIA), Department of Medical Oncology, Cochin Teaching Hospital, AP-HP, Paris Descartes University, Paris, France;
- bClinical Research Unit Paris Centre, INSERM CIC-P0901, AP-HP, Paris Descartes University, Paris, France;
- cCERIA, Department of Cardiology, Cochin Teaching Hospital, AP-HP, Paris Descartes University, Paris, France;
- dCERIA, Department of Nephrology, Necker Teaching Hospital, AP-HP, Paris Descartes University, Paris, France
- Correspondence: Olivier Mir, M.D., M.Sc., M.P.H., Department of Medical Oncology, Teaching Hospital Cochin, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint Jacques, F75014 Paris, France. Telephone: 33-158-411-439; Fax: 33-158-411-745; e-mail: olivier.mir{at}cch.aphp.fr
- Received January 3, 2010.
- Accepted June 1, 2011.
- First published online in THE ONCOLOGIST Express on August 1, 2011.
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Disclosures: Olivier Mir: None; Romain Coriat: None; Laure Cabanes: None; Stanislas Ropert: None; Bertrand Billemont: None; Jérôme Alexandre: None; Jean-Philippe Durand: Consultant/advisory role: MSD-Chibret (Merck & Co Inc. France); Jean-Marc Treluyer: None; Bertrand Knebelmann: None; François Goldwasser: None.
The content of this article has been reviewed by independent peer reviewers to ensure that it is balanced, objective, and free from commercial bias. No financial relationships relevant to the content of this article have been disclosed by the independent peer reviewers.
Abstract
Background. Hypertension is a common toxicity of bevacizumab, but the frequency of assessment of blood pressure and standardized grading remain to be defined. This study aimed to describe the incidence of bevacizumab-induced hypertension and factors associated with its development, then to retrospectively assess its relation with activity.
Patients and methods. One hundred nineteen patients with advanced or metastatic non-small cell lung cancer, colorectal cancer, or ovarian cancer receiving bevacizumab (2.5 mg/kg per week) and chemotherapy were eligible for this analysis. Blood pressure was measured at home twice daily according to international guidelines, and graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC), version 3.0, and the European Society of Hypertension (ESH) criteria.
Results. Home-based measurements detected significantly more cases of hypertension than in-clinic measurements did, according to the ESH criteria (54.6% versus 24.4%; p < .001) or the NCI-CTC (42.9% versus 22.7%; p = .0015). Very early hypertension (within 42 days, according to the ESH criteria) but not hypertension (occurring at any time during treatment period) was predictive of response (p = .0011 and p = .26, respectively).
Conclusions. Our preliminary results indicate that home-based measurement and grading according to the ESH criteria represents a reliable method to detect bevacizumab-induced hypertension. Whether hypertension is a biomarker of bevacizumab activity remains to be determined in a prospective study.
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