Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, No. 1 Youyi Road, Yuzhong District, Chongqing, 400016, China.
Department of Urology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Cancer Chemother Pharmacol. 2024 Jun;93(6):587-593. doi: 10.1007/s00280-024-04655-7. Epub 2024 Feb 25.
Proteinuria is a common complication after the application of bevacizumab therapy in patients with metastatic colorectal cancer, and severe proteinuria can lead to discontinuation of the drug. There is a lack of sophisticated means to predict bevacizumab-induced proteinuria, so the present study aims to predict bevacizumab-induced proteinuria using peripheral venous blood samples.
A total of 122 subjects were enrolled and underwent pre-treatment plasma markers, and we followed them for six months with proteinuria as the endpoint event. We then analyzed the clinical features and plasma markers for grade ≥ 2 proteinuria occurrence using machine learning to construct a model with predictive utility.
One hundred sixteen subjects were included in the statistical analysis. We found that high baseline systolic blood pressure, low baseline HGF, high baseline ET1, high baseline MMP2, and high baseline ACE1 were risk factors for the development of grade ≥ 2 proteinuria in patients with metastatic colorectal cancer who received bevacizumab. Then, we constructed a support vector machine model with a sensitivity of 0.889, a specificity of 0.918, a precision of 0.615, and an F1 score of 0.727.
We constructed a machine learning model for predicting grade ≥ 2 bevacizumab-induced proteinuria, which may provide proteinuria risk assessment for applying bevacizumab in patients with metastatic colorectal cancer.
贝伐珠单抗治疗转移性结直肠癌患者后常发生蛋白尿,严重者可导致药物停用。目前缺乏预测贝伐珠单抗相关性蛋白尿的方法,本研究旨在利用外周静脉血样本预测贝伐珠单抗相关性蛋白尿。
共纳入 122 例患者,进行预处理时的血浆标志物检测,以蛋白尿为终点事件随访 6 个月。然后,我们使用机器学习分析临床特征和血浆标志物,以构建具有预测效用的模型。
116 例患者纳入统计分析。我们发现基线收缩压高、基线 HGF 低、基线 ET1 高、基线 MMP2 高、基线 ACE1 高是转移性结直肠癌患者接受贝伐珠单抗治疗后发生 2 级及以上蛋白尿的危险因素。然后,我们构建了一个支持向量机模型,其灵敏度为 0.889,特异性为 0.918,精准度为 0.615,F1 得分为 0.727。
我们构建了一个用于预测 2 级及以上贝伐珠单抗相关性蛋白尿的机器学习模型,该模型可能为转移性结直肠癌患者应用贝伐珠单抗提供蛋白尿风险评估。