Incidence and risk of significantly raised blood pressure in cancer patients treated with bevacizumab: an updated meta-analysis
Incidence and risk of significantly raised blood pressure in cancer patients treated with bevacizumab: an updated meta-analysis
复制标题
接受贝伐珠单抗治疗的癌症患者血压显着升高的发生率和风险：更新的荟萃分析
DOI：
10.1007/s00228-010-0815-4
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发表时间：
2010-08-01
影响因子：
2.9
通讯作者：
Jiang, Yuan Ying
中科院分区：
文献类型：
--
作者：
An, Mao Mao;Zou, Zui;Jiang, Yuan Ying
目的：贝伐单抗是一种靶向血管内皮生长因子的人源化单克隆抗体。本研究的目的是为了更好地了解接受贝伐单抗治疗的癌症患者血压显著升高的总体发生率和风险。方法我们对PubMed、Cochrane图书馆、Embase和美国临床肿瘤学会会议上的相关随机对照试验（RCTs）进行了荟萃分析。采用随机效应模型计算总发病率、相对危险度（RRs）和95%置信区间（ci）。主要临床终点是血压显著升高（3级或以上）。结果19项随机对照试验共纳入12949例不同类型实体瘤的癌症患者。在接受贝伐单抗治疗的患者中，血压显著升高的总发生率为8% （95% CI 6-10%）。贝伐单抗治疗与发生显著血压升高的风险显著增加相关（RR 5.38, 95% CI 3.63-7.97）。接受贝伐单抗5和2.5 mg/kg /周治疗的患者血压显著升高的rr分别为7.17 （95% CI, 3.91-13.13）和4.11 （95% CI, 2.49-6.78）。在癌症患者中，接受每周5 mg/kg贝伐单抗治疗的肾癌（RR 13.77, 95% CI 2.28-83.15）和乳腺癌（RR 18.83, 95% CI 1.23-292.29）患者发生血压显著升高的风险更高。在本荟萃分析中纳入的患者中，在癌症治疗中加入贝伐单抗可显著增加血压显著升高的风险。风险可能是剂量依赖性的，并随肿瘤类型而变化。
PurposeBevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor. The aim of this study was to gain a better understanding of the overall incidence and risk of significantly raised blood pressure in cancer patients who receive bevacizumab therapy.MethodsWe performed a meta-analysis of relevant randomized controlled trials (RCTs) identified in PubMed, Cochrane library, Embase, and American Society of Clinical Oncology conferences. Overall incidence rates, relative risks (RRs), and 95% confidence intervals (CIs) were calculated using a random-effects model. The primary clinical endpoint was significantly raised blood pressure (grade 3 or above).ResultsA total of 12,949 cancer patients with a variety of solid tumors from 19 RCTs were included in our meta-analysis. The overall incidence of significantly raised blood pressure was 8% (95% CI 6–10%) among patients receiving bevacizumab. Bevacizumab treatment was associated with a statistically significant increased risk of developing significantly raised blood pressure (RR 5.38, 95% CI 3.63–7.97). The RRs of significantly raised blood pressure in patients receiving bevacizumab at 5 and 2.5 mg/kg per week were 7.17 (95% CI, 3.91–13.13) and 4.11 (95% CI 2.49–6.78), respectively. Among cancer patients, those with renal cell carcinoma (RR 13.77, 95% CI 2.28–83.15) and breast cancer (RR 18.83, 95% CI 1.23–292.29) who received bevacizumab at 5 mg/kg per week had a higher risk of developing significantly raised blood pressure.ConclusionsAmong the patients included in the trials analyzed in this meta-analysis, the addition of bevacizumab to cancer therapy treatments significantly increased the risk of significantly raised blood pressure. The risk may be dose-dependent and vary with tumor type.