Angiogenesis Inhibitors and Arterial Dissection or Aneurysm in Patients With Metastatic Colorectal Cancer

Area of Science:

• Oncology
• Vascular Medicine
• Pharmacovigilance

Background:

• Pharmacovigilance data and biological rationale suggest angiogenesis inhibitors may increase arterial dissection/aneurysm risk.
• Clinical evidence is needed to confirm or refute this association in real-world patient populations.

Purpose of the Study:

• To investigate the association between angiogenesis inhibitor exposure and arterial dissections or aneurysms in metastatic colorectal cancer (mCRC) patients.
• To evaluate risks based on exposure status, recency, and duration.

Main Methods:

• A nested case-control study utilized the French national health database (Système National des Données de Santé).
• Adults with mCRC treated with targeted therapies (2012-2017) formed the cohort; cases of arterial events were matched with controls.
• Conditional logistic regression analyzed associations, adjusting for cardiovascular risk.

Main Results:

• No significant association was found between angiogenesis inhibitor exposure (any, current, past, or cumulative duration) and arterial dissections/aneurysms (OR, 1.07; 95% CI, 0.75-1.52).
• The study included 195 cases and 1950 controls from a cohort of 34,733 patients.
• Results remained consistent across different exposure estimation methods.

Conclusions:

• This study provides reassuring clinical evidence that angiogenesis inhibitors are not associated with an increased risk of arterial dissections or aneurysms in mCRC patients.
• The findings support the continued use of these vital therapies, particularly bevacizumab, in mCRC treatment.