[Anti-angiogenic drugs and hypertension: from multidisciplinary collaboration to greater care]

Francesca Tunesi1, Marco Simonini1, Giulia Sabetta2

  • 1U.O. Nefrologia e Dialisi, IRCCS Ospedale San Raffaele, Milano, Italia; Università Vita Salute San Raffaele, Milano, Italia.

Insights

Bevacizumab effectively treats ovarian cancer by targeting tumor angiogenesis. Multidisciplinary care involving gynecologists and nephrologists is crucial for managing side effects like hypertension, ensuring treatment continuity.

Area of Science:

  • Oncology
  • Nephrology
  • Cardiovascular Medicine

Background:

  • Anti-angiogenic drugs, targeting vascular endothelial growth factor (VEGF) and its receptors, are vital in cancer therapy to inhibit tumor growth and metastasis.
  • Bevacizumab, a common anti-angiogenic agent, is associated with significant side effects including hypertension, acute kidney injury (AKI), and congestive heart failure.

Observation:

  • A retrospective study analyzed 57 ovarian cancer patients treated with Bevacizumab between 2015-2022.
  • The majority (98.2%) had FIGO stage 3 (G3) disease.
  • Hypertension developed in 49% of patients, with 82% experiencing grade 2 severity (CTCAE v.5).

Findings:

  • Multidisciplinary management, including nephrology consultation (68% of cases), was implemented for 89% of hypertensive patients.
  • Treatment discontinuation due to hypertension occurred in only 3 patients, with successful re-initiation in 2.
  • Effective management allowed continued anti-angiogenic therapy in most patients.

Implications:

  • Multidisciplinary evaluation by gynecologists and nephrologists is essential for minimizing Bevacizumab-related morbidity and mortality.
  • Proactive management of side effects like hypertension can prevent treatment interruptions in ovarian cancer patients.
  • This approach supports sustained oncological treatment and improves patient outcomes.

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