Correlation of hypertension and proteinuria with outcome in elderly bevacizumab-treated patients with metastatic colorectal cancer

• Published in: PloS one 2015-01, Vol.10 (1), p.e0116527-e0116527
• Main Authors: Feliu, Jaime, Salud, Antonieta, Safont, Maria J, García-Girón, Carlos, Aparicio, Jorge, Losa, Ferran, Bosch, Carlos, Escudero, Pilar, Casado, Enrique, Jorge, Monica, Bohn, Uriel, Pérez-Carrión, Ramon, Carmona, Alberto, Custodio, Ana B, Maurel, Joan
• Format: Article
• Language: English
• Subjects: Age; Aged; Aged, 80 and over; Analysis; Angiogenesis inhibitors; Antibodies, Monoclonal, Humanized - therapeutic use; Antineoplastic Combined Chemotherapy Protocols; Bevacizumab; Breast cancer; Cancer; Cancer metastasis; Cancer patients; Cancer therapies; Capecitabine; Care and treatment; Chemotherapy; Clinical Trials, Phase II as Topic; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - complications; Colorectal Neoplasms - drug therapy; Correlation analysis; Deoxycytidine - analogs & derivatives; Deoxycytidine - therapeutic use; Diabetes mellitus; Disease; Disease control; Disease-Free Survival; Female; Fluorouracil - analogs & derivatives; Fluorouracil - therapeutic use; Geriatrics; Health risks; Hemoglobin; Hospitals; Humans; Hypertension; Hypertension - complications; Immunotherapy; L-Lactate dehydrogenase; Lactate dehydrogenase; Lactic acid; Lesions; Lung cancer; Male; Metastases; Metastasis; Monoclonal antibodies; Multivariate Analysis; Older people; Organoplatinum Compounds - therapeutic use; Oxaliplatin; Patient outcomes; Patients; Prognosis; Proteinuria; Proteinuria - complications; Retrospective Studies; Risk analysis; Risk factors; Studies; Targeted cancer therapy; Treatment Outcome; Variables; Vascular endothelial growth factor
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0116527

Studies suggest a relationship between hypertension and outcome in bevacizumab-treated patients with metastatic colorectal cancer (mCRC). We performed a retrospective analysis of two phase II studies (BECA and BECOX) to determine if hypertension and proteinuria predict outcome in elderly patients with mCRC treated with bevacizumab. Patients ≥ 70 years of age received either capecitabine 1250 mg/m(2) bid days 1-14 + bevacizumab 7.5 mg/kg day 1 every 21 days (BECA study) or capecitabine 1000 mg/m(2) bid days 1-14 with bevacizumab 7.5 mg/kg and oxaliplatin 130 mg/m(2) day 1 (BECOX study). The primary objective was to correlate hypertension and proteinuria with overall response rate (ORR), time to progression (TTP) and overall survival (OS). Secondary objectives included identification of risk factors associated with the development of hypertension and proteinuria and determining whether development of hypertension or proteinuria in the first 2 cycles was related to ORR, disease-control rate (DCR), TTP or OS. In total, 127 patients (median age 75.5 years) were included in the study. Hypertension correlated with DCR and OS; proteinuria correlated with ORR and DCR. Proteinuria or hypertension in the first 2 cycles did not correlate with efficacy. Risk factors for hypertension were female gender (odds ratio [OR] 0.241; P = 0.011) and more bevacizumab cycles (OR 1.112; P = 0.002); risk factors for proteinuria were diabetes (OR 3.869; P = 0.006) and more bevacizumab cycles (OR 1.181; P