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Bevacizumab‐induced hypertension is a predictive marker for improved outcomes in patients with recurrent glioblastoma treated with bevacizumab
Author(s) -
Zhong Jim,
Ali Arif N.,
Voloschin Alfredo D.,
Liu Yuan,
Curran Walter J.,
Crocker Ian R.,
Shu HuiKuo G.
Publication year - 2015
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.29234
Subject(s) - bevacizumab , medicine , proportional hazards model , confidence interval , oncology , surgery , progression free survival , univariate analysis , multivariate analysis , chemotherapy
BACKGROUND Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor and is approved for the treatment of patients with recurrent glioblastoma (GBM). Previous authors have reported differential response to bevacizumab on an individual basis. Bevacizumab‐induced hypertension is a well‐documented side effect, and some reports have suggested this occurrence to be related to treatment outcome in other cancers. In the current study, the authors analyzed patients with recurrent GBM who were treated with bevacizumab based on whether the patients developed drug‐induced hypertension. METHODS All patients with GBM treated within the Emory Healthcare system from 2007 through 2012 were reviewed. A total of 82 patients were identified who received bevacizumab for the treatment of recurrent GBM and were included in the current study. Patients were classified as normotensive or hypertensive depending on whether hypertension developed that was attributable to therapy. Progression‐free survival (PFS) and overall survival (OS) were graphed by the Kaplan‐Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards method. RESULTS The median follow‐up was 19.7 months. Of the 82 patients with recurrent GBM who were treated with bevacizumab, 30 developed drug‐induced hypertension. The median time to the development of hypertension was 21 days. The median PFS for the normotensive and hypertensive groups were 2.5 months (95% confidence interval [95% CI], 1.6‐3.0 months) and 6.7 months (95% CI, 4.6‐10.0 months), respectively ( P <.001). The median OS times for the normotensive and hypertensive groups were 4.9 months (95% CI, 4.4‐6.8 months) and 11.7 months (95% CI, 9.0‐20.5 months), respectively ( P <.001). CONCLUSIONS Patients with recurrent GBM who developed bevacizumab‐induced hypertension demonstrated significantly better PFS and OS compared with normotensive individuals. Bevacizumab‐induced hypertension may be a physiologic marker of outcome in patients with recurrent GBM. Cancer 2015;121:1456–1462. © 2014 American Cancer Society .