Tongji Medical College, Cancer Center of Union Hospital, Huazhong University of Science and Technology, Wuhan, Hubei 430022, PR China.
World J Surg Oncol. 2013 Nov 28;11:306. doi: 10.1186/1477-7819-11-306.
With the wide application of targeted drug therapies, the relevance of prognostic and predictive markers in patient selection has become increasingly important. Bevacizumab is commonly used in combination with chemotherapy in the treatment of metastatic colorectal cancer. However, there are currently no predictive or prognostic biomarkers for bevacizumab. Several clinical studies have evaluated bevacizumab-induced hypertension in patients with metastatic colorectal cancer. This meta-analysis was performed to better determine the association of bevacizumab-induced hypertension with outcome in patients with metastatic colorectal cancer, and to assess whether bevacizumab-induced hypertension can be used as a prognostic factor in these patients.
We performed a systematic review and meta-analysis on seven published studies to investigate the relationship between hypertension and outcome of patients with metastatic colorectal cancer treated with bevacizumab. Our primary endpoint was progression-free survival (PFS). Secondary endpoints were overall survival (OS) and overall response rate (ORR). Hazard ratios (HRs) for PFS and OS were extracted from each trial, and the log of the relative risk ratio (RR) was estimated for ORR.
The occurrence of bevacizumab-induced hypertension in patients was highly associated with improvements in PFS (HR = 0.57, 95% CI: 0.46-0.72; P <0.001), OS (HR = 0.50; 95% CI: 0.37-0.68; P <0.001), and ORR (RR = 1.57, 95% CI: 1.07-2.30, P <0.05), as compared to patients without hypertension.
Bevacizumab-induced hypertension may represent a prognostic factor in patients with metastatic colorectal cancer.
随着靶向药物治疗的广泛应用，预测和预后标志物在患者选择中的相关性变得越来越重要。贝伐珠单抗通常与化疗联合用于转移性结直肠癌的治疗。然而，目前尚无贝伐珠单抗的预测或预后生物标志物。几项临床研究评估了转移性结直肠癌患者中贝伐珠单抗引起的高血压。本荟萃分析旨在更好地确定转移性结直肠癌患者中贝伐珠单抗引起的高血压与结局之间的关联，并评估贝伐珠单抗引起的高血压是否可作为这些患者的预后因素。
我们对 7 项已发表的研究进行了系统评价和荟萃分析，以研究接受贝伐珠单抗治疗的转移性结直肠癌患者的高血压与结局之间的关系。我们的主要终点是无进展生存期（PFS）。次要终点是总生存期（OS）和总缓解率（ORR）。从每个试验中提取 PFS 和 OS 的风险比（HR），并估计 ORR 的相对风险比（RR）的对数。
患者中贝伐珠单抗引起的高血压的发生与 PFS（HR = 0.57，95%CI：0.46-0.72；P <0.001）、OS（HR = 0.50；95%CI：0.37-0.68；P <0.001）和 ORR（RR = 1.57，95%CI：1.07-2.30，P <0.05）的改善高度相关。
贝伐珠单抗引起的高血压可能是转移性结直肠癌患者的预后因素。
