Shorter bevacizumab infusions do not increase the incidence of proteinuria and hypertension

• Published in: Annals of oncology Vol. 24; no. 4; pp. 960 - 965
• Main Authors: Shah, S.R., Gressett Ussery, S.M., Dowell, J.E., Marley, E., Liticker, J., Arriaga, Y., Verma, U.
• Format: Journal Article
• Language: English
• Published: Oxford Elsevier Ltd 01-04-2013; Oxford University Press
• Subjects: administration; Adult; Aged; Aged, 80 and over; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - adverse effects; Antineoplastic agents; Arterial hypertension. Arterial hypotension; Bevacizumab; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; colorectal cancer; Colorectal Neoplasms - complications; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - pathology; Disease Progression; Drug Administration Schedule; Female; Gastroenterology. Liver. Pancreas. Abdomen; Humans; hypertension; Hypertension - chemically induced; Hypertension - pathology; infusion; Infusions, Intravenous; Male; Medical sciences; Middle Aged; Nephrology. Urinary tract diseases; Pharmacology. Drug treatments; Prospective Studies; proteinuria; Proteinuria - chemically induced; Proteinuria - pathology; Stomach. Duodenum. Small intestine. Colon. Rectum. Anus; Tumors; Urinary system involvement in other diseases. Miscellaneous; Urinary tract. Prostate gland; bevacizumab; colorectal cancer; infusion; hypertension; administration; proteinuria; Antineoplastic agent; Hypertension; Urinary system disease; Rectal disease; Colorectal cancer; Cardiovascular disease; Monoclonal antibody; Malignant tumor; Epidemiology; Bevacizumab; Incidence; Colonic disease; Vascular endothelium growth factor; Perfusion; Digestive diseases; Intestinal disease; Antiangiogenic agent; Cancer; Proteinuria
• ISSN: 0923-7534; 1569-8041
• DOI: 10.1093/annonc/mds593

A previous study has shown that shorter bevacizumab infusions (0.5 mg/kg/min) can be safely administered without increasing the risk of infusion-related hypersensitivity reactions (HSRs). However, the risk of proteinuria and hypertension in patients receiving shorter infusions of bevacizumab is undetermined.
This was a multicenter, prospective, observational study in patients receiving <10 mg/kg of bevacizumab infused over 0.5 mg/kg/min. Patients were observed until discontinuation of bevacizumab for progression of cancer or toxicity. The incidence of hypertension and proteinuria was compared with a prior cohort of patients who had received standard duration infusions of bevacizumab.
Sixty-three patients received a total of 392 doses of shorter bevacizumab infusions. Nineteen (30.2%) patients experienced proteinuria while receiving bevacizumab. Out of 19 patients, 13 had grade 1 and 6 had grade 2 proteinuria. None of the patients experienced grade 3 or 4 proteinuria. Hypertension was reported in 32 (50.8%) patients receiving bevacizumab. Twelve (19%) patients developed grade 3 or greater hypertension on bevacizumab. The incidence of proteinuria and hypertension was 38.3% and 56.6%, respectively, in patients (N = 120, 1347 infusions) receiving standard duration infusions of bevacizumab.
Shorter bevacizumab infusions (0.5 mg/kg/min) do not increase the risk of proteinuria and hypertension.