TITLE:
Hypertensive Profile of Metastatic Colorectal Carcinoma Patients Treated with Bevacizumab—A Prospective Study
AUTHORS:
Aravindh S. Anand, Mintu Mathew Abraham, Jayalekshmi Velayudhan
KEYWORDS:
Bevacizumab, VEGF, Hypertension, Colorectal Cancer
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.7 No.2,
February
26,
2016
ABSTRACT: Background: Bevacizumab is a recombinant humanized monoclonal antibody which
targets Vasculoendothelial growth factor (VEGF)-A and prevents its binding to VEGF
receptor 2 (VEGFR 2). It is approved in the first and second line treatment of metastatic
colorectal cancer along with combination chemotherapy. Hypertension is an on-target
and a common side effect of the treatment with bevacizumab. The true incidence
of bevacizumab induced hypertension and its grading remains unclear due to
paucity of prospective studies in this regard. In our institution, majority of metastatic
colorectal cancer patients receive bevacizumab along with cytotoxic chemotherapy.
In Indian, a context prospective study on this topic is negligible; so we find
it to be of high importance. Objectives: We have conducted a prospective observational
study of all metastatic colorectal patients receiving bevacizumab with chemotherapy
and satisfying the eligibility criteria. The objective of the study was to assess
the incidence and the pattern of hypertension. Materials & Methods: Patients receiving bevacizumab with FOLFOX (5 Fluorouracil,
Calcium Leucovorin & Oxaliplatin) or CapeOX (Capecitabine & Oxaliplatin)
chemotherapy for metastatic colorectal cancer were enrolled in the study; blood
pressure was monitored before bevacizumab administration and also for the next seven
days. This was done for all the chemotherapy cycles. Results: 100% of patients developed
hypertension of any grade and 20% received treatment as a part of newly detected
hypertension. Majority of the patients
had grade 1 hypertension. Other grade of hypertension was grade 2. The blood pressure
peaked on 6th day of bevacizumab administration. Conclusions: Hypertension
of any grade may develop in bevacizumab treated patients. The incidence is very
high and it may reach even up to 100% if prospectively and meticulously evaluated
for longer period of time.