전이성 대장암 환자에서 혈관신생억제제 Bevacizumab 치료로 인한 혈전색전증 위험
Risk of Thromboembolism with the Angiogenesis inhibitor Bevacizumab in Metastatic Colo-Rectal Cancer Patients
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Combination treatment with bevacizumab and 5-fluorouracil (5-FU) based chemotherapy improves overall survival and progression free survival of patients with metastatic colo-rectal cancer (mCRC). But, arterial thromboembolism (ATE) and venous thromboembolism (VTE) were associated with bevacizumab, VEGF inhibitor. This study was performed to determine the risk of ATE and VTE associated with the use of bevacizumab. Total of 410 patients with m CRC who were administered combination treatment with bevacizumab and chemotherapy versus chemotherapy alone from January 2007 to August 2010 in Asan Medical Center were enrolled. Data was collected retrospectively from electronic medical record (EMR). The risk of thromboembolism (TE) was assessed by simple incidence rates and hazard ratios (HRs). The association between potential risk factors and TE was investigated by Cox proportional hazards regression. Combination treatment with Bevacizumab and chemotherapy, compared with chemotherapy alone, increased incidence rate of TE (9.8% vs 3.7%, p=0.018), VTE (6.1% vs 2%, p=0.038) and ATE (4.4% vs 1.7%, p=0.109). Univariate and multivariate HR of Bevacizumab group were respectively 3.09 (p=0.009), 5.90 (p=0.016). In conclusion, The use of bevacizumab was significantly associated with the increased risk of developing TE in mCRC receiving this drug. Further studies are needed to investigate the prevention and management of TE associated with bevacizumab.
Abstract
Combination treatment with bevacizumab and 5-fluorouracil (5-FU) based chemotherapy improves overall survival and progression free survival of patients with metastatic colo-rectal cancer (mCRC). But, arterial thromboembolism (ATE) and venous thromboembolism (VTE) were associated with bevacizumab, VEGF inhibitor. This study was performed to determine the risk of ATE and VTE associated with the use of bevacizumab. Total of 410 patients with m CRC who were administered combination treatment with bevacizumab and chemotherapy versus chemotherapy alone from January 2007 to August 2010 in Asan Medical Center were enrolled. Data was collected retrospectively from electronic medical record (EMR). The risk of thromboembolism (TE) was assessed by simple incidence rates and hazard ratios (HRs). The association between potential risk factors and TE was investigated by Cox proportional hazards regression. Combination treatment with Bevacizumab and chemotherapy, compared with chemotherapy alone, increased incidence rate of TE (9.8% vs 3.7%, p=0.018), VTE (6.1% vs 2%, p=0.038) and ATE (4.4% vs 1.7%, p=0.109). Univariate and multivariate HR of Bevacizumab group were respectively 3.09 (p=0.009), 5.90 (p=0.016). In conclusion, The use of bevacizumab was significantly associated with the increased risk of developing TE in mCRC receiving this drug. Further studies are needed to investigate the prevention and management of TE associated with bevacizumab.
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