Hypertension secondary to anti-angiogenic therapy: experience with bevacizumab

Anticancer Res. Sep-Oct 2007;27(5B):3465-70.

Abstract

Background: Hypertension (HT) is a common complication of anti-angiogenic therapy. Its incidence, treatment and complications are undefined.

Patients and methods: Retrospective review of patients treated with bevacizumab (BV) from 2003-5. Common toxicity criteria (CTC) for adverse events version 3.0 were used.

Results: Fifty-five out of the 154 patients treated with BV (35%) experienced HT. Eleven (20%) developed a new onset HT and 44 (80%) experienced an exacerbation of pre-existing HT. HT developed after a median of 11 weeks at a median BV dose of 10 mg/kg. HT severity was grade 1 (n =1), grade 2 (n=29) or grade 3 (n=22); 3 experienced hypertensive complications. HT was controlled in 47 (85%); BV was discontinued in 3. The angiotensin-converting enzyme inhibitor (ACE-I), quinapril was commonly used and resulted in better HT control than ACE-II, calcium channel or beta antagonists.

Conclusion: HT associated with bevacizumab therapy is a manageable toxicity with the use of ACE-I.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Angiogenesis Inhibitors / adverse effects*
  • Angiogenesis Inhibitors / therapeutic use*
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal / pharmacology
  • Antibodies, Monoclonal / therapeutic use*
  • Antibodies, Monoclonal, Humanized
  • Bevacizumab
  • Female
  • Humans
  • Hypertension / chemically induced*
  • Hypertension / epidemiology
  • Incidence
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / drug therapy*
  • Protein Kinase Inhibitors / pharmacology
  • United States / epidemiology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor Receptor-1 / metabolism
  • Vascular Endothelial Growth Factor Receptor-2 / metabolism

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Protein Kinase Inhibitors
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Vascular Endothelial Growth Factor Receptor-1
  • Vascular Endothelial Growth Factor Receptor-2