Bevacizumab-Induced Hypertension As a Potential Physiological Clinical Biomarker for Improved Outcomes in Patients With Recurrent Glioblastoma Multiforme: A Systematic Review

Overview

Journal Cureus

Specialty Biomedical Engineering

Date 2022 Oct 24

PMID 36277543

Authors

Kokab Irfan Khan

Prasana Ramesh

Suthasenthuran Kanagalingam

Fnu Zargham Ul Haq

Nishok Victory Srinivasan

Aujala Irfan Khan

Ghadi D Mashat

Mohammad Hazique

Safeera Khan

Affiliations

Soon will be listed here.

Abstract

With the advancement in medicine leading to the discovery of anti-vascular endothelial growth factor drugs, numerous oncologists are now commonly using antiangiogenic medications to improve outcomes and attain disease control. Thus, the significance of prognostic and predictive indicators in patient selection has become increasingly imperative. These biomarkers have the capacity to be highly effective and can easily be implemented in various diagnostic and therapeutic settings on a large scale. Overall, it has the potential of significantly decreasing mortality in a fatal disease and possibly achieving partial or complete remission. Many clinical trials have shown the efficacy of bevacizumab in treating malignancies. However, there are currently no known predictive or prognostic biomarkers for bevacizumab in glioblastoma multiforme (GBM). Several clinical studies have evaluated bevacizumab-induced hypertension as a potential marker in patients with different malignancies, including recurrent glioblastoma multiforme (rGBM). This systematic review was performed to determine the association of bevacizumab-induced hypertension with outcomes in patients with advanced brain cancer and to assess whether hypertension (HTN) can be used as a prognostic factor. The review was conducted according to Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines, and the databases were searched from January 2012 to June 2022. This review aimed to evaluate six published studies to investigate the relationship between hypertension and the outcomes of patients with rGBM treated with bevacizumab. Among the included publications, four out of six were retrospective and featured a positive result regarding hypertension being used as an independent predictive factor of survival outcomes in rGBM. However, two studies showed negative results. This can be attributed to the limited subsets of patients and the duration of the studies. In conclusion, bevacizumab-induced hypertension may represent a prognostic factor in patients with rGBM.

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References

Mir O, Coriat R, Cabanes L, Ropert S, Billemont B, Alexandre J . An observational study of bevacizumab-induced hypertension as a clinical biomarker of antitumor activity. Oncologist. 2011; 16(9):1325-32. PMC: 3228164. DOI: 10.1634/theoncologist.2010-0002. View

Cohen M, Shen Y, Keegan P, Pazdur R . FDA drug approval summary: bevacizumab (Avastin) as treatment of recurrent glioblastoma multiforme. Oncologist. 2009; 14(11):1131-8. DOI: 10.1634/theoncologist.2009-0121. View

Lu-Emerson C, Duda D, Emblem K, Taylor J, Gerstner E, Loeffler J . Lessons from anti-vascular endothelial growth factor and anti-vascular endothelial growth factor receptor trials in patients with glioblastoma. J Clin Oncol. 2015; 33(10):1197-213. PMC: 4517055. DOI: 10.1200/JCO.2014.55.9575. View

Lombardi P, Rossini D, Crespi V, Germani M, Bergamo F, Pietrantonio F . Bevacizumab-induced hypertension as a predictor of clinical outcome in metastatic colorectal cancer: An individual patient data-based pooled analysis of two randomized studies and a systematic review of the literature. Cancer Treat Rev. 2022; 103:102326. DOI: 10.1016/j.ctrv.2021.102326. View

Carvalho B, Lopes R, Linhares P, Costa A, Caeiro C, Fernandes A . Hypertension and proteinuria as clinical biomarkers of response to bevacizumab in glioblastoma patients. J Neurooncol. 2020; 147(1):109-116. DOI: 10.1007/s11060-020-03404-z. View

Page M, McKenzie J, Bossuyt P, Boutron I, Hoffmann T, Mulrow C . The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. Syst Rev. 2021; 10(1):89. PMC: 8008539. DOI: 10.1186/s13643-021-01626-4. View

Osterlund P, Soveri L, Isoniemi H, Poussa T, Alanko T, Bono P . Hypertension and overall survival in metastatic colorectal cancer patients treated with bevacizumab-containing chemotherapy. Br J Cancer. 2011; 104(4):599-604. PMC: 3049598. DOI: 10.1038/bjc.2011.2. View

Miller K, Ostrom Q, Kruchko C, Patil N, Tihan T, Cioffi G . Brain and other central nervous system tumor statistics, 2021. CA Cancer J Clin. 2021; 71(5):381-406. DOI: 10.3322/caac.21693. View

Zhong J, Ali A, Voloschin A, Liu Y, Curran Jr W, Crocker I . Bevacizumab-induced hypertension is a predictive marker for improved outcomes in patients with recurrent glioblastoma treated with bevacizumab. Cancer. 2015; 121(9):1456-62. DOI: 10.1002/cncr.29234. View

10.

Rini B, Halabi S, Rosenberg J, Stadler W, Vaena D, Archer L . Phase III trial of bevacizumab plus interferon alfa versus interferon alfa monotherapy in patients with metastatic renal cell carcinoma: final results of CALGB 90206. J Clin Oncol. 2010; 28(13):2137-43. PMC: 2860433. DOI: 10.1200/JCO.2009.26.5561. View

11.

Le Rhun E, Preusser M, Roth P, Reardon D, van den Bent M, Wen P . Molecular targeted therapy of glioblastoma. Cancer Treat Rev. 2019; 80:101896. DOI: 10.1016/j.ctrv.2019.101896. View

12.

Wagner C, Held U, Kofmehl R, Battegay E, Zimmerli L, Hofer S . Role of arterial hypertension as a predictive marker for bevacizumab efficacy in recurrent glioblastoma - a prospective analysis. Acta Oncol. 2013; 53(4):572-5. DOI: 10.3109/0284186X.2013.852240. View

13.

Ostrom Q, Cioffi G, Waite K, Kruchko C, Barnholtz-Sloan J . CBTRUS Statistical Report: Primary Brain and Other Central Nervous System Tumors Diagnosed in the United States in 2014-2018. Neuro Oncol. 2021; 23(12 Suppl 2):iii1-iii105. PMC: 8491279. DOI: 10.1093/neuonc/noab200. View

14.

Olsson A, Dimberg A, Kreuger J, Claesson-Welsh L . VEGF receptor signalling - in control of vascular function. Nat Rev Mol Cell Biol. 2006; 7(5):359-71. DOI: 10.1038/nrm1911. View

15.

Bumes E, Rzonsa S, Hutterer M, Proescholdt M, Bogdahn U, Riemenschneider M . Adverse event grading following CTCAE v3.0 underestimates hypertensive side effects in patients with glioma treated with Bevacizumab. J Neurooncol. 2016; 127(1):191-200. DOI: 10.1007/s11060-015-2031-7. View

16.

Liau C, Chou W, Wei K, Chang C, Toh C, Jung S . Female sex, good performance status, and bevacizumab-induced hypertension associated with survival benefit in Asian patients with recurrent glioblastoma treated with bevacizumab. Asia Pac J Clin Oncol. 2017; 14(2):e8-e14. DOI: 10.1111/ajco.12747. View

17.

De Stefano A, Carlomagno C, Pepe S, Bianco R, De Placido S . Bevacizumab-related arterial hypertension as a predictive marker in metastatic colorectal cancer patients. Cancer Chemother Pharmacol. 2011; 68(5):1207-13. DOI: 10.1007/s00280-011-1604-1. View

18.

Zhang T, Xin Q, Kang J . Bevacizumab for recurrent glioblastoma: a systematic review and meta-analysis. Eur Rev Med Pharmacol Sci. 2021; 25(21):6480-6491. DOI: 10.26355/eurrev_202111_27092. View

19.

Lombardi G, Zustovich F, Farina P, Fiduccia P, Della Puppa A, Polo V . Hypertension as a biomarker in patients with recurrent glioblastoma treated with antiangiogenic drugs: a single-center experience and a critical review of the literature. Anticancer Drugs. 2012; 24(1):90-7. DOI: 10.1097/CAD.0b013e32835aa5fd. View

20.

Gampenrieder S, Romeder F, Muss C, Pircher M, Ressler S, Rinnerthaler G . Hypertension as a predictive marker for bevacizumab in metastatic breast cancer: results from a retrospective matched-pair analysis. Anticancer Res. 2014; 34(1):227-33. View