Incidence and risk of significantly raised blood pressure in cancer patients treated with bevacizumab: an updated meta-analysis

An, Mao Mao; Zou, Zui; Shen, Hui; Liu, Ping; Chen, Meng Li; Cao, Yong; Jiang, Yuan

doi:10.1007/s00228-010-0815-4

Cited by 73 publications

(48 citation statements)

References 33 publications

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“…Indeed, several recent meta-analyses have shown that the use of bevacizumab significantly increases the risk of developing anti-VEGF adverse events, including hypertension [5], congestive heart failure (CHF) [6], arterial thrombosis [7], hemorrhage [8,9], proteinuria [10,11] and gastrointestinal perforation [12,13]. Additionally, high-grade infection (Grades 3-4) is a rare but potentially life-threatening adverse event with bevacizumab; this has been observed in clinical trials with an incidence ranging from 0% to 23.2% [14,15].…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

Zhang

et al. 2015

Critical Reviews in Oncology/Hematology

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Section: Introductionmentioning

confidence: 99%

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

Zhang

et al. 2015

Critical Reviews in Oncology/Hematology

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“…Studies show that the occurrence and the grade of the rash may correlate with the degree of response to therapy and pa ent survival in advanced cancer, with one-year survival being between 2 and 3 mes higher in pa ents that have had rashes and 35% [355][356][357]. It has been repeatedly confirmed that the response rates and the overall survival of the pa ents were significantly higher in pa ents that developed hypertension during treatment, compared with pa ents that did not [358,359]. Polymorphisms in the VEGF gene and the gene coding for the receptor VEGFR2, associated with development of hypertension during treatment with VEGF inhibitors have been recently iden fied [360].…”

Section: Individual Repair Capacity and The Risk Of Toxicity Of An Camentioning

confidence: 91%

Individual capacity for detoxification of genotoxic compounds and repair of DNA damage. Commonly used methods for assessment of capacity for DNA repair

Chakarov¹,

Petkova²,

Russev³

2014

Biodiscovery

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The first part of this paper reviews the major achievements in the rapidly expanding field of research of individual capacity for repair of genotoxic damage. The issues of individual repair capacity are addressed from mul ple sides, analyzing the impact of the heritable components of the capacity for detoxifica on of genotoxic compounds, on the one hand (determining the risk for occurrence of DNA damage) and of the capacity for repair of DNA damage (when it has already occurred), on the other hand. The role of the capacity for repair of damage to DNA is discussed in the cons tu on of the risk for development of disease (mainly cancer, but also other common diseases and condi ons, such as diabetes, atherosclerosis and cardiovascular disease) and as a major factor in the outcomes of genotoxic therapies (eligibility for therapy with specific agents, risk for severe adverse effects, post-therapeu c survival rates, etc.). The paper contains an extensive list of biomarkers (mainly DNA polymorphisms, but also enzymes and other phenotypic markers, such as markers of the capacity for self-renewal of cell popula ons) that may be poten ally applicable in the assessment of the risk for carcinogenesis or for development other types of human disease.The second part of the paper provides a brief glimpse of the basic methodology used to obtain experimental results in assessment of the efficiency of DNA repair in living cells for research and diagnos c purposes.Cita on: Chakarov S, Petkova R, Russev GCh. Individual capacity for detoxifica on of genotoxic compounds and repair of DNA damage. Commonly used methods for assessment of capacity for DNA repair.

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“…These authors found a non-significant trend towards a dose-effect relationship, with a risk ratio (RR) of 7.17 (95% CI 3.91-13.13) for a weekly dose of 5 mg/kg compared with a RR of 4.11 (95% CI 2.49-6.78) for a weekly dose of 2.5 mg/kg. The highest RRs were observed under bevacizumab (5 mg/kg/week) for renal cancer (RR 13.77; 95% CI 2.28-83.15) and for breast cancer (RR 18.8; 95% CI 1.23-292.3) [7]. Thus, the increased risk of elevated blood pressure under bevacizumab might be dose-dependent and might vary according to the location of the primitive tumor.…”

Section: Hypertension and Proteinuriamentioning

confidence: 94%

“…Anti-hypertensive treatment was prescribed de novo in about 11-16% of patients. According to a recent meta-analysis assessing 12,949 patients from 19 randomized controlled trials, the overall incidence of elevated blood pressure under bevacizumab reached 8% (6-10%) [7]. Bevacizumab was associated with a significantly increased risk raised blood pressure (RR 5.38; 95% Confidence Interval or CI 3.63-7.97).…”

Section: Hypertension and Proteinuriamentioning

confidence: 98%

Cardiovascular toxicity of anti-angiogenic drugs

et al. 2011

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Anti-angiogenic targeted therapies are now major tools in the management of solid tumors. Briefly, one can distinguish between monoclonal antibodies such as bevacizumab directed against vascular endothelial growth factor (VEGF) and small molecules such as those targeted against receptors with tyrosine-kinase activity. Soon after they were marketed, these drugs showed cardiovascular toxicities, such as hypertension, left ventricular systolic dysfunction, heart failure and conduction abnormalities. The most frequent cardiovascular side effect of targeted therapies is hypertension, but the most life-threatening is QT prolongation with its risk of torsade de pointe and sudden cardiac death. Since the incidence of different types of cardiovascular side effects following targeted therapies varies across studies-and despite the fact that several meta-analyses attempted to summarize available information-those side effects are still not well identified. In addition, their reversibility is not precisely known. This review aims to present and discuss the various cardiovascular toxicities of anti-angiogenic targeted therapies for cancer.

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Incidence and risk of significantly raised blood pressure in cancer patients treated with bevacizumab: an updated meta-analysis

Abstract: Among the patients included in the trials analyzed in this meta-analysis, the addition of bevacizumab to cancer therapy treatments significantly increased the risk of significantly raised blood pressure. The risk may be dose-dependent and vary with tumor type.

Cited by 73 publications

References 33 publications

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials

Individual capacity for detoxification of genotoxic compounds and repair of DNA damage. Commonly used methods for assessment of capacity for DNA repair

Cardiovascular toxicity of anti-angiogenic drugs

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