Department of Medical Oncology, Austin Health, Melbourne, Australia.
Ann Oncol. 2011 Aug;22(8):1834-8. doi: 10.1093/annonc/mdq702. Epub 2011 Jan 27.
Bevacizumab is an antiangiogenic mAb with efficacy against several cancers, but it is associated with risk of arterial thromboembolism (ATE). Further data are needed to determine the safety of bevacizumab.
We recorded grade 3, 4, or 5 ATE events and other data (including age, baseline cardiovascular risk factors, history of ATE, and aspirin use) from 471 patients with metastatic colorectal cancer in the MAX (Mitomycin, Avastin, Xeloda) trial of capecitabine monotherapy versus capecitabine with bevacizumab with or without mitomycin C.
Bevacizumab-treated patients had 12 grade 3, 4, or 5 ATEs (3.8% incidence). ATEs occurred in 2.1% of patients >65 years, 5% of those with a history of ATE, and 5% of those with cardiac risk factors. Age, history of ATE, or vascular risk factors did not increase risk. Aspirin users had a higher incidence than nonusers (8.9% versus 2.7%) but had higher rates of vascular risk factors.
Bevacizumab was associated with a modestly higher risk of ATE, but safety was not significantly worse in older patients or patients with a history of ATE or vascular risk factors. The effect of aspirin in preventing ATE in patients receiving bevacizumab could not be determined from this study.
贝伐单抗是一种抗血管生成单克隆抗体，对多种癌症有效，但与动脉血栓栓塞事件（ATE）的风险相关。需要进一步的数据来确定贝伐单抗的安全性。
我们从转移性结直肠癌的 MAX（丝裂霉素、贝伐单抗、卡培他滨）试验中记录了 471 例接受卡培他滨单药治疗与卡培他滨联合贝伐单抗加或不加丝裂霉素 C 治疗的患者中 3 级、4 级或 5 级 ATE 事件和其他数据（包括年龄、基线心血管危险因素、ATE 史和阿司匹林使用情况）。
贝伐单抗治疗组有 12 例 3 级、4 级或 5 级 ATE（发生率为 3.8%）。>65 岁的患者 ATE 发生率为 2.1%，有 ATE 史的患者为 5%，有心血管危险因素的患者为 5%。年龄、ATE 史或血管危险因素并未增加风险。阿司匹林使用者的发生率高于非使用者（8.9%比 2.7%），但血管危险因素的发生率更高。
贝伐单抗与 ATE 风险适度增加相关，但在老年患者或有 ATE 史或血管危险因素的患者中，安全性并未显著恶化。在接受贝伐单抗治疗的患者中，阿司匹林预防 ATE 的效果无法从这项研究中确定。
