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Hypertension and proteinuria as clinical biomarkers of response to bevacizumab in glioblastoma patients.
Journal of Neuro-Oncology ( IF 3.2 ) Pub Date : 2020-01-23 , DOI: 10.1007/s11060-020-03404-z
Bruno Carvalho 1, 2 , Rafaela Gonçalves Lopes 2 , Paulo Linhares 1, 2, 3 , Andreia Costa 4 , Cláudia Caeiro 4 , Ana Catarina Fernandes 4 , Nuno Tavares 4 , Lígia Osório 5 , Rui Vaz 1, 2, 3
Affiliation  

INTRODUCTION Arterial hypertension and proteinuria are common side effects of antiangiogenic treatment and might represent a biomarker of response in patients with glioblastoma. The aim of this study was to assess the impact of these side effects in predicting therapeutic response to second line chemotherapy with bevacizumab. METHODS We evaluated clinical and survival data of glioblastoma patients who underwent treatment with bevacizumab after progression under temozolomide, at CHUSJ between 2010 and 2017. We analysed treatment-related arterial hypertension, proteinuria grade, thrombotic and haemorrhagic events during treatment. Overall survival (OS) and progression free survival (PFS) under bevacizumab were calculated according to the Kaplan-Meier method. Multivariate analysis was performed using Cox proportional hazards method. RESULTS We evaluated 140 patients. Arterial hypertension and proteinuria occurred in 23 (16.3%) and 17 (12.1%) patients, respectively. PFS during treatment with bevacizumab was 12 months (95% CI 7.9-16.1) in the hypertensive group and 4 months (95% CI 3.2-4.8) in the normotensive group (p = 0.005). Patients with proteinuria had a PFS of 10 months (95% CI 4.9-15.0) versus 4 months (95% CI 3.4-4.8) in patients without proteinuria (p = 0.002). Multivariate analysis revealed hypertension and proteinuria as independent prognostic factors of PFS and OS. CONCLUSION Our data suggest that hypertension and proteinuria can be effective predictors of response to antiangiogenic therapy in recurrent glioblastoma and are associated with longer disease control.

中文翻译:

高血压和蛋白尿是胶质母细胞瘤患者对贝伐单抗反应的临床生物标志物。

简介动脉高压和蛋白尿是抗血管生成治疗的常见副作用,可能代表胶质母细胞瘤患者反应的生物标志物。这项研究的目的是评估这些副作用在预测贝伐单抗对二线化疗的治疗反应中的影响。方法我们评估了2010年至2017年间在CHUSJ接受替莫唑胺治疗后成年胶质母细胞瘤患者的临床和生存数据。我们分析了治疗期间与治疗相关的动脉高血压,蛋白尿分级,血栓形成和出血事件。根据Kaplan-Meier方法计算贝伐单抗的总生存期(OS)和无进展生存期(PFS)。使用Cox比例风险方法进行多变量分析。结果我们评估了140例患者。动脉高血压和蛋白尿分别发生在23(16.3%)和17(12.1%)患者中。高血压组贝伐单抗治疗期间的PFS为12个月(95%CI 7.9-16.1),血压正常组为4个月(95%CI 3.2-4.8)(p = 0.005)。蛋白尿患者的PFS为10个月(95%CI 4.9-15.0),而无蛋白尿的患者则为4个月(95%CI 3.4-4.8)(p = 0.002)。多变量分析显示高血压和蛋白尿是PFS和OS的独立预后因素。结论我们的数据表明,高血压和蛋白尿症可以有效预测复发性胶质母细胞瘤中抗血管生成治疗的反应,并与更长的疾病控制时间有关。1%)的患者。高血压组贝伐单抗治疗期间的PFS为12个月(95%CI 7.9-16.1),血压正常组为4个月(95%CI 3.2-4.8)(p = 0.005)。蛋白尿患者的PFS为10个月(95%CI 4.9-15.0),而无蛋白尿的患者则为4个月(95%CI 3.4-4.8)(p = 0.002)。多变量分析显示高血压和蛋白尿是PFS和OS的独立预后因素。结论我们的数据表明,高血压和蛋白尿症可以有效预测复发性胶质母细胞瘤中抗血管生成治疗的反应,并与更长的疾病控制时间有关。1%)的患者。高血压组贝伐单抗治疗期间的PFS为12个月(95%CI 7.9-16.1),血压正常组为4个月(95%CI 3.2-4.8)(p = 0.005)。蛋白尿患者的PFS为10个月(95%CI 4.9-15.0),而无蛋白尿的患者则为4个月(95%CI 3.4-4.8)(p = 0.002)。多变量分析显示高血压和蛋白尿是PFS和OS的独立预后因素。结论我们的数据表明,高血压和蛋白尿症可以有效预测复发性胶质母细胞瘤中抗血管生成治疗的反应,并与更长的疾病控制时间有关。蛋白尿患者的PFS为10个月(95%CI 4.9-15.0),而无蛋白尿的患者则为4个月(95%CI 3.4-4.8)(p = 0.002)。多变量分析显示高血压和蛋白尿是PFS和OS的独立预后因素。结论我们的数据表明,高血压和蛋白尿症可以有效预测复发性胶质母细胞瘤中抗血管生成治疗的反应,并与更长的疾病控制时间有关。蛋白尿患者的PFS为10个月(95%CI 4.9-15.0),而无蛋白尿的患者则为4个月(95%CI 3.4-4.8)(p = 0.002)。多变量分析显示高血压和蛋白尿是PFS和OS的独立预后因素。结论我们的数据表明,高血压和蛋白尿症可以有效预测复发性胶质母细胞瘤中抗血管生成治疗的反应,并与更长的疾病控制时间有关。
更新日期:2020-01-23
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