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Updated: Aug 13, 2025

Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion
Published on: May 26, 2022
[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.
Abstract:
Anti-angiogenic drugs are widely used in cancer therapy. Their main targets of action are the vascular endothelial growth factor (VEGF) and its receptors (VEGF-R). Anti-angiogenic drugs are used to reduce the growth of the tumor and its metastases by acting on the phenomenon of tumor neo-angiogenesis. However, they are known for their side effects such as hypertension, acute kidney injury (AKI), and congestive heart failure. Methods: retrospective study conducted on 57 consecutive patients known for ovarian cancer. Patients treated with Bevacizumab, as first-line, relapse, or maintenance treatment (2015-2022). Results: according to FIGO staging, 98.2% (56 out of 57) of the patients in the study had third degree disease (G3). 49% of patients developed hypertension after starting Bevacizumab therapy (82% grade 2 according to CTCAE v.5). 89% of hypertensive patients started treatment and its management was multidisciplinary with nephrological consultation in 68% of cases. Only 3 out of 57 women discontinued treatment due to hypertension, and in only one of them it was not possible to restart it. Conclusions: the evaluation of the patient by a multidisciplinary team (gynecologist and nephrologist) is essential to minimize the morbidity and mortality of patients, and to avoid the interruption of antineoplastic treatment.
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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