전이성 결장직장암 환자에서 사용되는 bevacizumab의 고혈압 발현양상 및 임상적 결과와의 상관관계 분석
Hypertension and Clinical Outcome in Metastatic Colorectal Cancer Patients Treated with Bevacizumab
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Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF). It has been suggested that hypertension could be due to capillary rarefaction and decreased nitric oxide synthesis caused by inhibition of the VEGF pathway. Based on this hypothesis, we analyzed the possible association between bevacizumab-induced hypertension and clinical outcome in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. We conducted a retrospective chart review of patients with mCRC treated with bevacizumab at Samsung Medical Center, from January to December 2009. Blood pressure was increased, according to common toxicity criteria for adverse events (CTCAE) version 4.0 scale. A total of 102 mCRC patients were eligible and 30 patients (29.4%) developed grade 2-3 hypertension. A complete or partial response was observed in 19 of the 30 (63.3%) patients with bevacizumab-related hypertension, and in 20 of the 72 (27.8%) patients with no hypertension (p = 0.001). Patients who developed hypertension showed a longer median progression-free survival (36.6 weeks) when compared with patients without hypertension (28.1 weeks), but this difference was not statistically significant (p = 0.149). Our results suggest that bevacizumab-induced hypertension may be a potential surrogate bio-marker of the clinical outcome in mCRC patients treated with bevacizumab.
Abstract
Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF). It has been suggested that hypertension could be due to capillary rarefaction and decreased nitric oxide synthesis caused by inhibition of the VEGF pathway. Based on this hypothesis, we analyzed the possible association between bevacizumab-induced hypertension and clinical outcome in metastatic colorectal cancer (mCRC) patients treated with bevacizumab. We conducted a retrospective chart review of patients with mCRC treated with bevacizumab at Samsung Medical Center, from January to December 2009. Blood pressure was increased, according to common toxicity criteria for adverse events (CTCAE) version 4.0 scale. A total of 102 mCRC patients were eligible and 30 patients (29.4%) developed grade 2-3 hypertension. A complete or partial response was observed in 19 of the 30 (63.3%) patients with bevacizumab-related hypertension, and in 20 of the 72 (27.8%) patients with no hypertension (p = 0.001). Patients who developed hypertension showed a longer median progression-free survival (36.6 weeks) when compared with patients without hypertension (28.1 weeks), but this difference was not statistically significant (p = 0.149). Our results suggest that bevacizumab-induced hypertension may be a potential surrogate bio-marker of the clinical outcome in mCRC patients treated with bevacizumab.
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