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不良心血管事件可预测接受贝伐单抗治疗的非小细胞肺癌患者的生存获益。

Adverse cardiovascular events predict survival benefit in non-small lung cancer patients treated with bevacizumab.

作者信息

Koyama N

机构信息

Division of Pulmonary Medicine, Clinical Department of Internal Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan Department of Respiratory Medicine, Saitama Medical University International Medical Center, Saitama, Japan.

出版信息

Cancer Biomark. 2014;14(4):259-65. doi: 10.3233/CBM-140404.

Abstract

BACKGROUND

Bevacizumab is a monoclonal antibody against vascular endothelial growth factor (VEGF) that provides a survival benefit to patients with non-small cell lung cancer (NSCLC). However, the treatment is sometimes accompanied by life-threatening bleeding events, and studies have not yet identified factors that can predict outcomes for NSCLC patients receiving bevacizumab.

METHODS

To identify prognostic factors for patients with NSCLC who are undergoing bevacizumab therapy, this study retrospectively investigated 34 consecutive patients with NSCLC treated with bevacizumab-containing chemotherapy.

RESULTS

Adverse cardiovascular events, including hypertension and bleeding events, during bevacizumab therapy were observed in 18 patients (53%). Kaplan-Meier survival analyses and log-rank tests revealed that median overall survival was significantly better in patients who experienced adverse cardiovascular events than those who did not (442 versus 304 days; P=0.012). In the multivariate Cox proportional hazard model, the onset of adverse cardiovascular events was independently associated with a better overall survival.

CONCLUSIONS

The onset of adverse cardiovascular events during bevacizumab therapy may be a favorable prognostic factor for patients with NSCLC. The results of this retrospective study warrant further large-scale prospective trials.

摘要

背景

贝伐单抗是一种抗血管内皮生长因子(VEGF)的单克隆抗体,可使非小细胞肺癌(NSCLC)患者受益。然而,该治疗有时会伴随危及生命的出血事件,且研究尚未确定可预测接受贝伐单抗治疗的NSCLC患者预后的因素。

方法

为了确定接受贝伐单抗治疗的NSCLC患者的预后因素,本研究回顾性调查了连续34例接受含贝伐单抗化疗的NSCLC患者。

结果

18例患者(53%)在贝伐单抗治疗期间出现不良心血管事件,包括高血压和出血事件。Kaplan-Meier生存分析和对数秩检验显示,发生不良心血管事件的患者的中位总生存期显著长于未发生不良心血管事件的患者(442天对304天;P=0.012)。在多变量Cox比例风险模型中,不良心血管事件的发生与更好的总生存期独立相关。

结论

贝伐单抗治疗期间不良心血管事件的发生可能是NSCLC患者的一个有利预后因素。这项回顾性研究的结果需要进一步的大规模前瞻性试验。

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