Kesumayadi Irfan, Kambe Atsushi, Amisaki Hidefumi, Hosoya Tomohiro, Sakamoto Makoto, Kurosaki Masamichi
Department of Brain and Neurosciences, Division of Neurosurgery, Faculty of Medicine, Tottori University, Tottori, Japan.
J Neurooncol. 2025 Sep 9. doi: 10.1007/s11060-025-05209-4.
Hypertension, the most common adverse events associated with bevacizumab (BEV) treatment, has been proposed as a potential biomarker of treatment response in glioblastoma (GBM) patients. This study aimed to evaluate whether the timing of hypertension serves as a prognostic value in GBM patients.
This retrospective study consisting of 56 GBM patients treated with initial BEV between 2013 and 2024. Blood pressure was monitored peri-infusion of BEV (before and 60 min after). Patients were grouped into normotension, pre-existing hypertension (before first BEV infusion), and BEV-induced hypertension, further classified as early new-onset (≤ 3 cycles) or late-onset (> 3 cycles). Overall survival (OS) was assessed using the Kaplan-Meier method.
Fifteen (36.6%) patients had pre-existing hypertension, while 26 (63.4%) were normotensive at baseline. Among the normotensive patients, twelve (46.1%) developed early new-onset hypertension, and 13 (50%) developed late-onset hypertension. Patients with pre-existing hypertension demonstrated significantly longer median OS compared to normotensive patients (32 vs. 22 months, p = 0.043). Early new-onset hypertension was also associated with improved OS compared to patients who remained normotensive after three cycles (25 vs. 16 months, p = 0.003). Additionally, patients with pre-existing and early new-onset hypertension showed longer OS compared to those with late-onset hypertension (25 vs. 14 months, p = 0.002).
Monitoring blood pressure during peri-infusion of BEV could be useful in predicting treatment response for GBM patients. Pre-existing or early new-onset hypertension is associated with improved survival, suggesting that timing of hypertension has a potential role as a biomarker for BEV efficacy.
高血压是与贝伐单抗（BEV）治疗相关的最常见不良事件，已被提议作为胶质母细胞瘤（GBM）患者治疗反应的潜在生物标志物。本研究旨在评估高血压的发生时间对GBM患者是否具有预后价值。
这项回顾性研究纳入了2013年至2024年间接受初始BEV治疗的56例GBM患者。在BEV输注期间（输注前和输注后60分钟）监测血压。患者分为血压正常、既往高血压（首次BEV输注前）和BEV诱导的高血压，后者进一步分为早期新发（≤3个周期）或晚期发生（>3个周期）。采用Kaplan-Meier方法评估总生存期（OS）。
15例（36.6%）患者有既往高血压，而26例（63.4%）患者基线时血压正常。在血压正常的患者中，12例（46.1%）出现早期新发高血压，13例（50%）出现晚期高血压。与血压正常的患者相比，有既往高血压的患者中位OS显著更长（32个月对22个月，p = 0.043）。与三个周期后仍血压正常的患者相比，早期新发高血压也与OS改善相关（25个月对16个月，p = 0.003）。此外，有既往高血压和早期新发高血压的患者比晚期高血压患者的OS更长（25个月对14个月，p = 0.002）。
在BEV输注期间监测血压可能有助于预测GBM患者的治疗反应。既往或早期新发高血压与生存期改善相关，提示高血压的发生时间可能作为BEV疗效的生物标志物发挥潜在作用。
