Abstract
Purpose
Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor. The aim of this study was to gain a better understanding of the overall incidence and risk of significantly raised blood pressure in cancer patients who receive bevacizumab therapy.
Methods
We performed a meta-analysis of relevant randomized controlled trials (RCTs) identified in PubMed, Cochrane library, Embase, and American Society of Clinical Oncology conferences. Overall incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. The primary clinical endpoint was significantly raised blood pressure (grade 3 or above).
Results
A total of 12,949 cancer patients with a variety of solid tumors from 19 RCTs were included in our meta-analysis. The overall incidence of significantly raised blood pressure was 8% (95% CI 6–10%) among patients receiving bevacizumab. Bevacizumab treatment was associated with a statistically significant increased risk of developing significantly raised blood pressure (RR 5.38, 95% CI 3.63–7.97). The RRs of significantly raised blood pressure in patients receiving bevacizumab at 5 and 2.5 mg/kg per week were 7.17 (95% CI, 3.91–13.13) and 4.11 (95% CI 2.49–6.78), respectively. Among cancer patients, those with renal cell carcinoma (RR 13.77, 95% CI 2.28–83.15) and breast cancer (RR 18.83, 95% CI 1.23–292.29) who received bevacizumab at 5 mg/kg per week had a higher risk of developing significantly raised blood pressure.
Conclusions
Among the patients included in the trials analyzed in this meta-analysis, the addition of bevacizumab to cancer therapy treatments significantly increased the risk of significantly raised blood pressure. The risk may be dose-dependent and vary with tumor type.
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Acknowledgments
We are indebted to the authors of the primary studies; without their contributions, this work would have been impossible. We thank Yu GZ and Xue LJ for consulting on eligible studies.
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The authors state that they have no conflict of interest.
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Mao Mao An and Zui Zou contributed equally to this article and can be considered to be co-first authors.
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An, M.M., Zou, Z., Shen, H. et al. Incidence and risk of significantly raised blood pressure in cancer patients treated with bevacizumab: an updated meta-analysis. Eur J Clin Pharmacol 66, 813–821 (2010). https://doi.org/10.1007/s00228-010-0815-4
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DOI: https://doi.org/10.1007/s00228-010-0815-4