Bruno Carvalho1,2, Rafaela Gonçalves Lopes3, Paulo Linhares4,3,5, Andreia Costa6, Cláudia Caeiro6, Ana Catarina Fernandes6, Nuno Tavares6, Lígia Osório7, Rui Vaz4,3,5. 1. Department of Neurosurgery, Centro Hospitalar Universitário S. João, Porto, Portugal. bmfcarvalho@gmail.com. 2. Faculty of Medicine, University of Porto, Porto, Portugal. bmfcarvalho@gmail.com. 3. Faculty of Medicine, University of Porto, Porto, Portugal. 4. Department of Neurosurgery, Centro Hospitalar Universitário S. João, Porto, Portugal. 5. Neurosciences Center - CUF Hospital, Porto, Portugal. 6. Department of Oncology, Centro Hospitalar Universitário S. João, Porto, Portugal. 7. Department of Radiotherapy, Centro Hospitalar Universitário S. João, Porto, Portugal.
Abstract
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.
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 glioblastomapatients 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.
Authors: M José Ortiz-Morales; Marta Toledano-Fonseca; Rafael Mena-Osuna; M Teresa Cano; Auxiliadora Gómez-España; Juan R De la Haba-Rodríguez; Antonio Rodríguez-Ariza; Enrique Aranda Journal: Cancers (Basel) Date: 2022-06-21 Impact factor: 6.575
Authors: Bruno Carvalho; José Manuel Lopes; Roberto Silva; Joana Peixoto; Dina Leitão; Paula Soares; Ana Catarina Fernandes; Paulo Linhares; Rui Vaz; Jorge Lima Journal: Sci Rep Date: 2021-03-16 Impact factor: 4.379