Bevacizumab dose affects the severity of adverse events in gynecologic malignancies
Journal
Frontiers in Pharmacology
Journal Volume
10
Journal Issue
4
Date Issued
2019
Author(s)
Abstract
In this retrospective study, we investigated adverse events and outcomes in patients treated with bevacizumab for ovarian, fallopian tube, or primary peritoneal cancers at a single hospital. We determined the cumulative incidences of various bevacizumab-related adverse events and the correlation between dose and adverse event incidences. We analyzed data from 154 patients that received 251 rounds of bevacizumab as first-line, first salvage, >2 salvage treatments. Adverse events of any grade were observed in 121 (78.6%) patients; at least one grade 3 or 4 adverse event occurred in 32 (20.8%) patients. The two most common events were proteinuria (38.3%) and hypertension (33.8%). The first-line treatment group displayed significantly higher frequencies of hypertension (52.7% vs. 18.9% vs. 15.5%, p < 0.001), wound complications (9.1% vs. 0% vs. 1.2%, p = 0.010), arthralgia (29.1% vs. 11.3% vs. 8.3%, p = 0.003), and reduced range of joint motion (14.5% vs. 5.7% vs. 3.6%, p = 0.046), compared to those in the first and >2 lines salvage groups, respectively (Kruskal-Wallis test). The cumulative incidences of all grades and grades 3/4 of hypertension cumulative incidence plateaued at around 30% for all grades and 10% for grades 3 and 4, at bevacizumab doses above 8080 and 3510 mg, respectively. The proteinuria cumulative incidence plateaued at around 35% for all grades and 3% for grades 3 and 4, at bevacizumab doses above 11,190 and 4530 mg, respectively. We concluded that, in this realistic clinical population, different kinds and higher cumulative incidences of adverse events were observed compared to those reported in previous clinical trials. Moreover, bevacizumab doses showed cumulative toxicity and plateau effects on hypertension and proteinuria. Copyright ? 2019 Lee, Hsu, Tai, Chen, Chiang, Chen and Cheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
SDGs
Other Subjects
bevacizumab; cyclophosphamide; paclitaxel; platinum; adult; aged; arthralgia; Article; cancer combination chemotherapy; cancer grading; cancer staging; cancer survival; cytoreductive surgery; digestive system perforation; drug efficacy; drug response; fallopian tube cancer; fallopian tube cancer; female; female genital tract cancer; gastrointestinal hemorrhage; hemicolectomy; human; hypertension; maintenance therapy; major clinical study; musculoskeletal pain; outcome assessment; ovary cancer; overall survival; peritoneum cancer; prescription; proteinuria; range of motion; respiratory tract hemorrhage; retrospective study; salvage therapy; survival rate; thromboembolism; treatment duration; treatment outcome; very elderly; wound complication
Type
journal article