Hypertension secondary to anti-angiogenic therapy: experience with bevacizumab.
BACKGROUND
Hypertension (HT) is a common complication of anti-angiogenic therapy. Its incidence, treatment and complications are undefined.


METHODS
Retrospective review of patients treated with bevacizumab (BV) from 2003-5. Common toxicity criteria (CTC) for adverse events version 3.0 were used.


RESULTS
Fifty-five out of the 154 patients treated with BV (35%) experienced HT. Eleven (20%) developed a new onset HT and 44 (80%) experienced an exacerbation of pre-existing HT. HT developed after a median of 11 weeks at a median BV dose of 10 mg/kg. HT severity was grade 1 (n =1), grade 2 (n=29) or grade 3 (n=22); 3 experienced hypertensive complications. HT was controlled in 47 (85%); BV was discontinued in 3. The angiotensin-converting enzyme inhibitor (ACE-I), quinapril was commonly used and resulted in better HT control than ACE-II, calcium channel or beta antagonists.


CONCLUSIONS
HT associated with bevacizumab therapy is a manageable toxicity with the use of ACE-I.
Pande
Amitkumar
A
Department of Medicine, Roswell Park Cancer Institute, Elm and Carlton Sts, Buffalo, NY 14263, USA.
Lombardo
Jeffrey
J
Spangenthal
Edward
E
Javle
Milind
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020533:Angiogenesis Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000494:pharmacology / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000188:drug therapy*; D047428:Protein Kinase Inhibitors / Q000494:pharmacology; D014481:United States / Q000453:epidemiology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000378:metabolism; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000378:metabolism
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D047428:Protein Kinase Inhibitors; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2