Suppr
超能文献

贝伐珠单抗引起的高血压是复发性胶质母细胞瘤患者接受贝伐珠单抗治疗后改善预后的预测标志物。

Bevacizumab-induced hypertension is a predictive marker for improved outcomes in patients with recurrent glioblastoma treated with bevacizumab.

机构信息

Department of Radiation Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.

出版信息

Cancer. 2015 May 1;121(9):1456-62. doi: 10.1002/cncr.29234. Epub 2014 Dec 29.

DOI:10.1002/cncr.29234

PMID:25557543

Abstract

BACKGROUND

Bevacizumab is a monoclonal antibody targeting vascular endothelial growth factor and is approved for the treatment of patients with recurrent glioblastoma (GBM). Previous authors have reported differential response to bevacizumab on an individual basis. Bevacizumab-induced hypertension is a well-documented side effect, and some reports have suggested this occurrence to be related to treatment outcome in other cancers. In the current study, the authors analyzed patients with recurrent GBM who were treated with bevacizumab based on whether the patients developed drug-induced hypertension.

METHODS

All patients with GBM treated within the Emory Healthcare system from 2007 through 2012 were reviewed. A total of 82 patients were identified who received bevacizumab for the treatment of recurrent GBM and were included in the current study. Patients were classified as normotensive or hypertensive depending on whether hypertension developed that was attributable to therapy. Progression-free survival (PFS) and overall survival (OS) were graphed by the Kaplan-Meier method. Univariate and multivariate analyses were performed using the Cox proportional hazards method.

RESULTS

The median follow-up was 19.7 months. Of the 82 patients with recurrent GBM who were treated with bevacizumab, 30 developed drug-induced hypertension. The median time to the development of hypertension was 21 days. The median PFS for the normotensive and hypertensive groups were 2.5 months (95% confidence interval [95% CI], 1.6-3.0 months) and 6.7 months (95% CI, 4.6-10.0 months), respectively (P<.001). The median OS times for the normotensive and hypertensive groups were 4.9 months (95% CI, 4.4-6.8 months) and 11.7 months (95% CI, 9.0-20.5 months), respectively (P<.001).

CONCLUSIONS

Patients with recurrent GBM who developed bevacizumab-induced hypertension demonstrated significantly better PFS and OS compared with normotensive individuals. Bevacizumab-induced hypertension may be a physiologic marker of outcome in patients with recurrent GBM.

摘要

背景

贝伐单抗是一种针对血管内皮生长因子的单克隆抗体，已被批准用于治疗复发性胶质母细胞瘤（GBM）患者。先前的作者已经报告了个体对贝伐单抗的不同反应。贝伐单抗引起的高血压是一种有据可查的副作用，一些报告表明这种发生与其他癌症的治疗结果有关。在目前的研究中，作者根据患者是否发生药物引起的高血压，分析了接受贝伐单抗治疗的复发性 GBM 患者。

方法

回顾了 2007 年至 2012 年期间在埃默里医疗保健系统接受治疗的所有 GBM 患者。共确定了 82 名接受贝伐单抗治疗复发性 GBM 的患者，并纳入了本研究。根据是否因治疗而发生高血压，将患者分为正常血压或高血压。通过 Kaplan-Meier 方法绘制无进展生存期（PFS）和总生存期（OS）。使用 Cox 比例风险方法进行单变量和多变量分析。

结果

中位随访时间为 19.7 个月。在 82 名接受贝伐单抗治疗的复发性 GBM 患者中，30 名患者发生了药物引起的高血压。高血压发生的中位时间为 21 天。正常血压组和高血压组的中位 PFS 分别为 2.5 个月（95%置信区间[95%CI]，1.6-3.0 个月）和 6.7 个月（95%CI，4.6-10.0 个月）（P<.001）。正常血压组和高血压组的中位 OS 时间分别为 4.9 个月（95%CI，4.4-6.8 个月）和 11.7 个月（95%CI，9.0-20.5 个月）（P<.001）。