TY - JOUR
T1 - Risks of Proteinuria and Hypertension With Bevacizumab, an Antibody Against Vascular Endothelial Growth Factor
T2 - Systematic Review and Meta-Analysis
AU - Zhu, Xiaolei
AU - Wu, Shenhong
AU - Dahut, William L.
AU - Parikh, Chirag R.
N1 - Funding Information:
Patient characteristics of 1,850 patients from the 7 clinical trials are listed in Table 1 . Baseline proteinuria was reported in only 2 publications. In 1 trial, patients with urine protein excretion greater than 500 mg/24 h were excluded 1 ; in 2 trials, patients with any evidence of proteinuria were excluded. 11,12 Hypertension was not mentioned as a preexisting condition in any trial. Ninety-one percent of patients with renal cancer underwent nephrectomy in the study by Yang et al. 6 Treatment options in all 7 trials were randomly assigned. All trials were sponsored by Genentech Inc. The study by Hurwitz et al 1 in 2004 was supported in part by the National Cancer Institute.
PY - 2007/2
Y1 - 2007/2
N2 - Background: Angiogenesis inhibitors have emerged as an effective targeted therapy in the treatment of patients with many cancers. One of the most widely used angiogenesis inhibitors is bevacizumab, a neutralizing antibody against vascular endothelial growth factor. The overall risk of proteinuria and hypertension in patients with cancer on bevacizumab therapy is unclear. We performed a systematic review and meta-analysis of published clinical trials of bevacizumab to quantify the risk of proteinuria and hypertension. Methods: The databases MEDLINE (OVID, 1966 to June 2006) and Web of Science and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 through 2006 were searched to identify relevant studies. Eligible studies were randomized controlled trials of patients with cancer treated with bevacizumab that described the incidence of proteinuria and hypertension. Relative risk (RR) was calculated by using the fixed-effects model. Results: A total of 1,850 patients were included in the 7 trials identified from the literature. Bevacizumab was associated with a significant increased risk of proteinuria (RR, 1.4 with low-dose bevacizumab; 95% confidence interval [CI], 1.1 to 1.7; RR, 2.2 with high dose; 95% CI, 1.6 to 2.9). Hypertension also was increased significantly among patients receiving bevacizumab (RR, 3.0 for low dose; 95% CI, 2.2 to 4.2; RR, 7.5 for high dose; 95% CI, 4.2 to 13.4). Conclusion: There was a significant dose-dependent increase in risk of proteinuria and hypertension in patients with cancer who received bevacizumab.
AB - Background: Angiogenesis inhibitors have emerged as an effective targeted therapy in the treatment of patients with many cancers. One of the most widely used angiogenesis inhibitors is bevacizumab, a neutralizing antibody against vascular endothelial growth factor. The overall risk of proteinuria and hypertension in patients with cancer on bevacizumab therapy is unclear. We performed a systematic review and meta-analysis of published clinical trials of bevacizumab to quantify the risk of proteinuria and hypertension. Methods: The databases MEDLINE (OVID, 1966 to June 2006) and Web of Science and abstracts presented at the American Society of Clinical Oncology annual meetings from 2004 through 2006 were searched to identify relevant studies. Eligible studies were randomized controlled trials of patients with cancer treated with bevacizumab that described the incidence of proteinuria and hypertension. Relative risk (RR) was calculated by using the fixed-effects model. Results: A total of 1,850 patients were included in the 7 trials identified from the literature. Bevacizumab was associated with a significant increased risk of proteinuria (RR, 1.4 with low-dose bevacizumab; 95% confidence interval [CI], 1.1 to 1.7; RR, 2.2 with high dose; 95% CI, 1.6 to 2.9). Hypertension also was increased significantly among patients receiving bevacizumab (RR, 3.0 for low dose; 95% CI, 2.2 to 4.2; RR, 7.5 for high dose; 95% CI, 4.2 to 13.4). Conclusion: There was a significant dose-dependent increase in risk of proteinuria and hypertension in patients with cancer who received bevacizumab.
KW - Bevacizumab
KW - anti-VEGF antibody
KW - cancer
KW - hypertension
KW - proteinuria
KW - vascular endothelial growth factor (VEGF)
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U2 - 10.1053/j.ajkd.2006.11.039
DO - 10.1053/j.ajkd.2006.11.039
M3 - Article
C2 - 17261421
AN - SCOPUS:33846638744
SN - 0272-6386
VL - 49
SP - 186
EP - 193
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -