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Bevacizumab-induced hypertension associated with improved OS, PFS in glioblastoma
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Patients with recurrent glioblastoma who experienced bevacizumab-induced hypertension demonstrated prolonged OS and PFS, according to study results.
The findings suggest bevacizumab-induced hypertension may be a marker of outcome in this patient population, researchers wrote.
“A topic at one of our weekly Winship Cancer Institute Grand Rounds was on predictive biomarkers in oncology, and there was some discussion about hypertension as a marker of response to angiogenesis inhibitors in a variety of solid tumors,” Hui-Kuo G. Shu, MD, PhD, associate professor in the department of radiation oncology at Winship Cancer Institute of Emory University, told HemOnc Today. “However, no data was available as to whether this factor was predictive of response to anti-angiogenic therapy in glioblastomas. Because bevacizumab is increasingly used for patients with recurrent glioblastomas, we have been interested in finding predictive biomarkers for tumor response to bevacizumab and decided to explore this question in our patient cohort at Emory.”
Shu and colleagues evaluated data from 82 patients treated with bevacizumab (Avastin, Genentech) between 2007 and 2012. The median age of the population was 57 years.
Median follow-up was 19.7 months.
Overall, 30 patients (37%) developed bevacizumab-induced hypertension within a median of 21 days of treatment. A majority (57%) of these patients had grade 2 hypertension, and 43% had grade 3 hypertension.
Patients who developed bevacizumab-induced hypertension demonstrated a median PFS of 6.7 months, which was significantly longer than the 2.5-month median PFS observed in the normotensive cohort (P˂.001).
Median OS also was significantly longer among patients who developed hypertension (11.7 months vs. 4.9 months; P˂.001).
Multivariate analyses indicated drug-induced hypertension was significantly associated with a reduced risk for progression (HR=0.23; 95% CI, 0.13-0.41) and death (HR=0.25; 95% CI, 0.15-0.44).
“[Because] hypertension is prognostic in recurrent glioblastoma patients treated with bevacizumab, we would suggest trying to keep patients on this therapy even if they develop hypertension as a side effect,” Shu said. “We would encourage aggressive blood pressure management in this situation so that patients can be maintained on a potentially efficacious treatment.”
Yet, additional research into this association is necessary, Shu said.
“We would like to identify genetic markers that are associated with development of bevacizumab-associated hypertension,” Shu said. “We believe that such genetic biomarkers will ultimately prove superior this phenotypic (hypertension) biomarker.” – by Alexandra Todak
Hui-Kuo G. Shu, MD, PhD, can be reached at the department of radiation oncology, Winship Cancer Institute, Emory University, 1365 Clifton Road Northeast, Room C-5092, Atlanta, GA 30322; email: hgshu@emory.edu.
Disclosure: The researchers report no relevant financial disclosures.
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