title: An observational study of bevacizumab-induced hypertension as a clinical biomarker of antitumor activity.
abstract: BACKGROUND
  Hypertension is a common toxicity of bevacizumab, but the frequency of assessment of blood pressure and standardized grading remain to be defined. This study aimed to describe the incidence of bevacizumab-induced hypertension and factors associated with its development, then to retrospectively assess its relation with activity.
  
  
  METHODS
  One hundred nineteen patients with advanced or metastatic non-small cell lung cancer, colorectal cancer, or ovarian cancer receiving bevacizumab (2.5 mg/kg per week) and chemotherapy were eligible for this analysis. Blood pressure was measured at home twice daily according to international guidelines, and graded according to the National Cancer Institute Common Toxicity Criteria (NCI-CTC), version 3.0, and the European Society of Hypertension (ESH) criteria.
  
  
  RESULTS
  Home-based measurements detected significantly more cases of hypertension than in-clinic measurements did, according to the ESH criteria (54.6% versus 24.4%; p < .001) or the NCI-CTC (42.9% versus 22.7%; p = .0015). Very early hypertension (within 42 days, according to the ESH criteria) but not hypertension (occurring at any time during treatment period) was predictive of response (p = .0011 and p = .26, respectively).
  
  
  CONCLUSIONS
  Our preliminary results indicate that home-based measurement and grading according to the ESH criteria represents a reliable method to detect bevacizumab-induced hypertension. Whether hypertension is a biomarker of bevacizumab activity remains to be determined in a prospective study.
authors.affiliation: Department of Medical Oncology, Teaching Hospital Cochin, AP-HP, Université Paris Descartes, 27 Rue du Faubourg Saint Jacques, F75014 Paris, France. olivier.mir@cch.aphp.fr
authors.forename: Olivier
authors.initials: O
authors.lastname: Mir
authors.forename: Romain
authors.initials: R
authors.lastname: Coriat
authors.forename: Laure
authors.initials: L
authors.lastname: Cabanes
authors.forename: Stanislas
authors.initials: S
authors.lastname: Ropert
authors.forename: Bertrand
authors.initials: B
authors.lastname: Billemont
authors.forename: Jérôme
authors.initials: J
authors.lastname: Alexandre
authors.forename: Jean-Philippe
authors.initials: JP
authors.lastname: Durand
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Treluyer
authors.forename: Bertrand
authors.initials: B
authors.lastname: Knebelmann
authors.forename: François
authors.initials: F
authors.lastname: Goldwasser
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage / Q000009:adverse effects*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D000068258:Bevacizumab; D001795:Blood Pressure Determination; D018660:Blood Pressure Monitoring, Ambulatory; D005260:Female; D006801:Humans; D006973:Hypertension / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000503:physiopathology*; D011446:Prospective Studies; D015203:Reproducibility of Results
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab