Impact of prior bevacizumab therapy on the incidence of ramucirumab-induced proteinuria in colorectal cancer: a multi-institutional cohort study

• Published in: International journal of clinical oncology 2023-08, Vol.28 (8), p.1054-1062
• Main Authors: Dote, Satoshi, Shiwaku, Eiji, Kohno, Emiko, Fujii, Ryohei, Mashimo, Keiji, Morimoto, Naomi, Yoshino, Masaki, Odaira, Naoki, Ikesue, Hiroaki, Hirabatake, Masaki, Takahashi, Katsuyuki, Takahashi, Masaya, Takagi, Mari, Nishiuma, Satoshi, Ito, Kaori, Shimato, Akane, Itakura, Shoji, Takahashi, Yoshitaka, Negoro, Yutaka, Shigemori, Mina, Watanabe, Hiroyuki, Hayasaka, Dai, Nakao, Masahiko, Tasaka, Misaki, Goto, Emi, Kataoka, Noriaki, Yokomizo, Ayako, Kobayashi, Ayako, Nakata, Yoko, Miyake, Mafumi, Hayashi, Yaeko, Yamamoto, Yoshie, Hirata, Taiki, Azuma, Kanako, Makihara, Katsuya, Fukui, Rino, Tokutome, Akira, Yagisawa, Keiji, Honda, Shinji, Meguro, Yuji, Suzuki, Shota, Yamaguchi, Daisuke, Miyata, Hitomi, Kobayashi, Yuka
• Format: Article
• Language: English
• Subjects: 5-Fluorouracil; Antineoplastic Combined Chemotherapy Protocols - adverse effects; Bevacizumab; Bevacizumab - adverse effects; Camptothecin - adverse effects; Cancer Research; Cohort Studies; Colonic Neoplasms - pathology; Colorectal cancer; Colorectal carcinoma; Colorectal Neoplasms - pathology; Comorbidity; Fluorouracil - adverse effects; Folinic acid; Humans; Incidence; Irinotecan; Leucovorin - adverse effects; Medicine; Medicine & Public Health; Metastases; Oncology; Original; Original Article; Proteinuria; Proteinuria - chemically induced; Ramucirumab; Rectal Neoplasms; Surgical Oncology; Survival; Toxicity; Vascular endothelial growth factor
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-023-02357-3

Background The association between prior bevacizumab (BEV) therapy and ramucirumab (RAM)-induced proteinuria is not known. We aimed to investigate this association in patients with metastatic colorectal cancer (mCRC). Methods mCRC patients who received folinic acid, fluorouracil, and irinotecan (FOLFIRI) plus RAM were divided into with and without prior BEV treatment groups. The cumulative incidence of grade 2–3 proteinuria and rate of RAM discontinuation within 6 months (6M) after RAM initiation were compared between the two groups. Results We evaluated 245 patients. In the Fine-Gray subdistribution hazard model including prior BEV, age, sex, comorbidities, eGFR, proteinuria ≥ 2 + at baseline, and later line of RAM, prior BEV treatment contributed to proteinuria onset ( P