[Anti-angiogenic drugs and hypertension: from multidisciplinary collaboration to greater care]

G Ital Nefrol. 2022 Dec 21;39(6):2022-vol6.
[Article in Italian]

Abstract

Anti-angiogenic drugs are widely used in cancer therapy. Their main targets of action are the vascular endothelial growth factor (VEGF) and its receptors (VEGF-R). Anti-angiogenic drugs are used to reduce the growth of the tumor and its metastases by acting on the phenomenon of tumor neo-angiogenesis. However, they are known for their side effects such as hypertension, acute kidney injury (AKI), and congestive heart failure. Methods: retrospective study conducted on 57 consecutive patients known for ovarian cancer. Patients treated with Bevacizumab, as first-line, relapse, or maintenance treatment (2015-2022). Results: according to FIGO staging, 98.2% (56 out of 57) of the patients in the study had third degree disease (G3). 49% of patients developed hypertension after starting Bevacizumab therapy (82% grade 2 according to CTCAE v.5). 89% of hypertensive patients started treatment and its management was multidisciplinary with nephrological consultation in 68% of cases. Only 3 out of 57 women discontinued treatment due to hypertension, and in only one of them it was not possible to restart it. Conclusions: the evaluation of the patient by a multidisciplinary team (gynecologist and nephrologist) is essential to minimize the morbidity and mortality of patients, and to avoid the interruption of antineoplastic treatment.

Keywords: anti-angiogenic drugs; hypertension; kidney injury; multidisciplinary team; ovarian cancer; proteinuria.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Angiogenesis Inhibitors / adverse effects
  • Bevacizumab / adverse effects
  • Female
  • Humans
  • Hypertension* / drug therapy
  • Neoplasms*
  • Retrospective Studies
  • Vascular Endothelial Growth Factor A / metabolism
  • Vascular Endothelial Growth Factor A / therapeutic use

Substances

  • Angiogenesis Inhibitors
  • Bevacizumab
  • Vascular Endothelial Growth Factor A