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R. Tanaka
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P2.03b - Poster Session with Presenters Present (ID 465)
- Event: WCLC 2016
- Type: Poster Presenters Present
- Track: Advanced NSCLC
- Presentations: 1
- Moderators:
- Coordinates: 12/06/2016, 14:30 - 15:45, Hall B (Poster Area)
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P2.03b-095 - Retrospective Analysis of Correlation between ACEIs/ARBs and Clinical Outcome in Lung Cancer Patients with Bevacizumab-Based Chemotherapy (ID 6187)
14:30 - 14:30 | Author(s): R. Tanaka
- Abstract
Background:
Background: Bevacizumab (BEV), a humanized recombinant monoclonal antibody that targets vascular endothelial growth factor, is widely used in cancer treatment. BEV treatment is generally well-tolerated, however, patients who are treated with BEV have an increased risk of developing systemic adverse events, such as hypertension and proteinuria. We generally use angiotensin I-converting enzyme inhibitors (ACEIs) and angiotensin II type-1 receptor blockers (ARBs) as a treatment of these adverse events. This group of drugs has been found to reduce proteinuria and prevent the development of glomeruloscrelosis. Additionally, since angiotensin II stimulates neovascularization, and thus act as a growth factor for cancer, previous studies have suggested that ACEIs and ARBs might decrease tumor growth and tumor-associated angiogenesis and inhibit metastasis. In this study, we aimed to investigate the correlation between proteinuria/ hypertension and clinical outcome, and between ACEIs/ARBs use and clinical outcome in lung cancer patients treated with BEV-based chemotherapy.
Methods:
Patients and Method: We retrospectively reviewed medical charts of patients at Kobe Red Cross Hospital and Kurashiki Central Hospital between November 2009 and February 2014. All patients were treated with BEV in combination with standard chemotherapy, such as pemetrexed plus platinum doublet, as first or second-line treatment. Cox regression analysis was performed to identify factors associated with antitumor response, overall survival (OS), and progression free survival (PFS).
Results:
Results: Among 122 patients, almost 30 patients were excluded because of diabetes mellitus and use of .BEV in late lines. Ninety-nine patients were included in the analysis set. Median treated BEV cycles were 7 cycles. Median OS and median PFS were 13.0 months and 6.2 months, respectively. During the study, proteinuria was found in 56 patients (57 %). Hypertension was found in 81 patients (82 %). Thirty-nine patients (39 %) were treated with ACEIs/ ARBs, 26 patients with other drugs. Univariate analysis showed that younger age, BEV cycles, and ACEIs/ARBs use were significantly associated with longer PFS, not OS. Younger age and BEV cycles were associated with PFS (P = .030 and < 0.001, respectively) on multivariate analysis, however, proteinuria, hypertension, and ACEIs/ ARBs use were not. There was however a trend for the correlation between ACEIs/ ARBs use and anti-tumor response (p = 0.082).
Conclusion:
Conclusion: Our results suggest that BEV-related proteinuria and hypertension were not prognostic markers for lung cancer patients treated with BEV-based chemotherapy. Further accumulation of patients is needed to assess the potential effect of ACEIs/ ARBs on anti-tumor effect and PFS.
