Wei-Xiang Qi1, Shen Fu, Qing Zhang, Xiao-Mao Guo. 1. Department of Radiation Oncology, Fudan University Shanghai Cancer Center, 270 Dong'An Road, Shanghai, 200032, China, qiweixiang1113@163.com.
Abstract
BACKGROUND AND OBJECTIVE: Congestive heart failure (CHF) risk with bevacizumab in breast cancer has been previously investigated in a meta-analysis, but its incidence and the risk of CHF in other tumor types remain unclear. Thus, we performed this meta-analysis to gather current data and evaluate the risk of CHF with bevacizumab in cancer patients, with a focus on different subgroups. METHODS: The databases of PubMed and abstracts presented at the American Society of Clinical Oncology up to 31 December 2013 were searched for relevant articles. Statistical analyses were conducted to calculate the summary incidence, relative risk (RR), and 95 % confidence intervals (CIs) by using either random-effects or fixed-effect models according to the heterogeneity of included studies. RESULTS: A total of 16,962 patients from 19 RCTs were included. The use of bevacizumab significantly increased the risk of developing high-grade CHF in cancer patients (RR 1.98, 95 % CI 1.30-3.02, p = 0.002), but not for all-grade CHF (RR 1.14, 95 % CI 0.87-1.49, p = 0.33). Risk might vary with bevacizumab dose and tumor types. RRs for patients receiving bevacizumab at 5 and 2.5 mg/kg/week were 2.25 (95 % CI 1.43-3.56) and 1.00 (95 % CI 0.33-3.05), respectively. High risks were observed in patients with breast cancer (RR 2.43, 95 % CI 1.48-3.98), renal cell cancer (RR 3.66, 95 % CI 0.41-33.01), and glioblastoma (RR 4.90, 95 % CI 0.24-102.39). Additionally, bevacizumab in combination with taxanes significantly increased the risk of high-grade CHF (RR 2.15, 95 % CI 1.09-4.25, p = 0.027). CONCLUSIONS: Bevacizumab treatment significantly increases the risk of developing high-grade CHF in cancer patients. The risk may vary with bevacizumab dose and tumor types. Clinicians should be aware of the risks of CHF with the administration of this drug in cancer patients.
BACKGROUND AND OBJECTIVE:Congestive heart failure (CHF) risk with bevacizumab in breast cancer has been previously investigated in a meta-analysis, but its incidence and the risk of CHF in other tumor types remain unclear. Thus, we performed this meta-analysis to gather current data and evaluate the risk of CHF with bevacizumab in cancerpatients, with a focus on different subgroups. METHODS: The databases of PubMed and abstracts presented at the American Society of Clinical Oncology up to 31 December 2013 were searched for relevant articles. Statistical analyses were conducted to calculate the summary incidence, relative risk (RR), and 95 % confidence intervals (CIs) by using either random-effects or fixed-effect models according to the heterogeneity of included studies. RESULTS: A total of 16,962 patients from 19 RCTs were included. The use of bevacizumab significantly increased the risk of developing high-grade CHF in cancerpatients (RR 1.98, 95 % CI 1.30-3.02, p = 0.002), but not for all-grade CHF (RR 1.14, 95 % CI 0.87-1.49, p = 0.33). Risk might vary with bevacizumab dose and tumor types. RRs for patients receiving bevacizumab at 5 and 2.5 mg/kg/week were 2.25 (95 % CI 1.43-3.56) and 1.00 (95 % CI 0.33-3.05), respectively. High risks were observed in patients with breast cancer (RR 2.43, 95 % CI 1.48-3.98), renal cell cancer (RR 3.66, 95 % CI 0.41-33.01), and glioblastoma (RR 4.90, 95 % CI 0.24-102.39). Additionally, bevacizumab in combination with taxanes significantly increased the risk of high-grade CHF (RR 2.15, 95 % CI 1.09-4.25, p = 0.027). CONCLUSIONS:Bevacizumab treatment significantly increases the risk of developing high-grade CHF in cancerpatients. The risk may vary with bevacizumab dose and tumor types. Clinicians should be aware of the risks of CHF with the administration of this drug in cancerpatients.
Authors: Toni K Choueiri; Erica L Mayer; Youjin Je; Jonathan E Rosenberg; Paul L Nguyen; Georges R Azzi; Joaquim Bellmunt; Harold J Burstein; Fabio A B Schutz Journal: J Clin Oncol Date: 2011-01-04 Impact factor: 44.544
Authors: Timothy J Perren; Ann Marie Swart; Jacobus Pfisterer; Jonathan A Ledermann; Eric Pujade-Lauraine; Gunnar Kristensen; Mark S Carey; Philip Beale; Andrés Cervantes; Christian Kurzeder; Andreas du Bois; Jalid Sehouli; Rainer Kimmig; Anne Stähle; Fiona Collinson; Sharadah Essapen; Charlie Gourley; Alain Lortholary; Frédéric Selle; Mansoor R Mirza; Arto Leminen; Marie Plante; Dan Stark; Wendi Qian; Mahesh K B Parmar; Amit M Oza Journal: N Engl J Med Date: 2011-12-29 Impact factor: 91.245
Authors: Kathy D Miller; Linnea I Chap; Frankie A Holmes; Melody A Cobleigh; P Kelly Marcom; Louis Fehrenbacher; Maura Dickler; Beth A Overmoyer; James D Reimann; Amy P Sing; Virginia Langmuir; Hope S Rugo Journal: J Clin Oncol Date: 2005-02-01 Impact factor: 44.544
Authors: David W Miles; Arlene Chan; Luc Y Dirix; Javier Cortés; Xavier Pivot; Piotr Tomczak; Thierry Delozier; Joo Hyuk Sohn; Louise Provencher; Fabio Puglisi; Nadia Harbeck; Guenther G Steger; Andreas Schneeweiss; Andrew M Wardley; Andreas Chlistalla; Gilles Romieu Journal: J Clin Oncol Date: 2010-05-24 Impact factor: 44.544
Authors: Krishnansu S Tewari; Michael W Sill; Harry J Long; Richard T Penson; Helen Huang; Lois M Ramondetta; Lisa M Landrum; Ana Oaknin; Thomas J Reid; Mario M Leitao; Helen E Michael; Bradley J Monk Journal: N Engl J Med Date: 2014-02-20 Impact factor: 91.245
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Marina T Van Leeuwen; Steven Luu; Howard Gurney; Martin R Brown; Sallie-Anne Pearson; Kate Webber; Lee Hunt; Soojung Hong; Geoffrey P Delaney; Claire M Vajdic Journal: JNCI Cancer Spectr Date: 2020-08-24