Plasma levels of VEGF‐A and VCAM‐1 as predictors of drug‐induced hypertension in patients treated with VEGF pathway inhibitors

Abstract

Hypertension is a common toxicity induced by vascular endothelial growth factor (VEGF) pathway inhibitors. There are no validated markers of hypertension induced by these drugs.Methods: We previously discovered that cancer patients with lower plasma levels of angiopoietin-2, VCAM-1 and VEGF-A are at high risk of developing severe hypertension when treated with bevacizumab. This study aimed to validate the predictive value of these markers in pretreatment plasma samples of an additional cohort of 101 colorectal cancer patients treated with regorafenib. The levels of angiopoietin-2, VCAM-1 and VEGF-A were measured by enzyme-linked immunosorbent assay (ELISA). The association between proteins and grade ≥2 regorafenib-induced hypertension was performed by calculating the odds ratio (OR) from logistic regression.Using the optimal cut-point of each protein, sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for hypertension were estimated.

Established and Emerging Cancer Therapies and Cardiovascular System: Focus on Hypertension—Mechanisms and Mitigation

“…62 Exploration has already begun into potential novel biomarkers, such as VEGF-A and VCAM-1 (vascular cell adhesion protein 1), which may be utilized to predict hypertension in VEGFi-treated patients. Most recently a study by Quintanilha et al 63 found lower levels of these markers to be significant predictors of hypertension in colorectal patients treated with Regorafenib. Although not available in clinical use currently markers such as these may potentially path the way for tailored dosage regimens for patients and better help clinicians assess hypertensive risk and in doing so reduce treatment discontinuation or interruption.…”