R&D Center of New Drug, School of Pharmacy, Second Military Medical University, 325 Guo He Road, Shanghai 200433, People's Republic of China.
Eur J Clin Pharmacol. 2010 Aug;66(8):813-21. doi: 10.1007/s00228-010-0815-4. Epub 2010 Apr 17.
Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor. The aim of this study was to gain a better understanding of the overall incidence and risk of significantly raised blood pressure in cancer patients who receive bevacizumab therapy.
We performed a meta-analysis of relevant randomized controlled trials (RCTs) identified in PubMed, Cochrane library, Embase, and American Society of Clinical Oncology conferences. Overall incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. The primary clinical endpoint was significantly raised blood pressure (grade 3 or above).
A total of 12,949 cancer patients with a variety of solid tumors from 19 RCTs were included in our meta-analysis. The overall incidence of significantly raised blood pressure was 8% (95% CI 6-10%) among patients receiving bevacizumab. Bevacizumab treatment was associated with a statistically significant increased risk of developing significantly raised blood pressure (RR 5.38, 95% CI 3.63-7.97). The RRs of significantly raised blood pressure in patients receiving bevacizumab at 5 and 2.5 mg/kg per week were 7.17 (95% CI, 3.91-13.13) and 4.11 (95% CI 2.49-6.78), respectively. Among cancer patients, those with renal cell carcinoma (RR 13.77, 95% CI 2.28-83.15) and breast cancer (RR 18.83, 95% CI 1.23-292.29) who received bevacizumab at 5 mg/kg per week had a higher risk of developing significantly raised blood pressure.
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.
贝伐珠单抗是一种针对血管内皮生长因子的人源化单克隆抗体。本研究旨在更好地了解接受贝伐珠单抗治疗的癌症患者中血压显著升高的总体发生率和风险。
我们对 PubMed、Cochrane 图书馆、Embase 和美国临床肿瘤学会会议中确定的相关随机对照试验（RCT）进行了荟萃分析。使用随机效应模型计算总体发生率、相对风险（RR）和 95%置信区间（CI）。主要临床终点为血压显著升高（等级 3 或以上）。
共有来自 19 项 RCT 的 12949 例患有各种实体瘤的癌症患者纳入本荟萃分析。接受贝伐珠单抗治疗的患者中血压显著升高的总体发生率为 8%（95%CI 6-10%）。贝伐珠单抗治疗与发生血压显著升高的风险显著增加相关（RR 5.38，95%CI 3.63-7.97）。接受每周 5mg/kg 和 2.5mg/kg 贝伐珠单抗治疗的患者血压显著升高的 RR 分别为 7.17（95%CI，3.91-13.13）和 4.11（95%CI 2.49-6.78）。在癌症患者中，每周接受 5mg/kg 贝伐珠单抗治疗的肾细胞癌（RR 13.77，95%CI 2.28-83.15）和乳腺癌（RR 18.83，95%CI 1.23-292.29）患者血压显著升高的风险更高。
在本荟萃分析中纳入的试验患者中，将贝伐珠单抗添加到癌症治疗中显著增加了血压显著升高的风险。该风险可能与剂量有关，且因肿瘤类型而异。
