Análisis de Factores de Riesgo de Hipertensión Severa Inducida por Bevacizumab en el Tratamiento de Cáncer de Mama...

Bevacizumab (BV) is used in combination with paclitaxel to treat human epidermal growth factor receptor 2-negative advanced breast cancer. However, BV frequently causes hypertension. Because patients with advanced breast cancer already have an elevated cardiovascular risk, we investigated clinical factors associated with BV-induced severe hypertension in a real-world setting.

Patients with advanced breast cancer receiving BV with paclitaxel (n=67) were retrospectively evaluated. The primary endpoint was determination of factors for the occurrence of grade ≥3 severe hypertension, considering clinical significance. We also assessed the time to symptom onset and variation in blood pressure after treatment between specific patient groups.

Hypertension occurred in 73.1% of the patients, with grades 2 and 3 severity in 20.9% and 52.2%, respectively. Multivariate logistic regression analysis suggested that pre-existing hypertension at baseline was an independent risk factor for grade ≥3 hypertension (adjusted hazard ratio=3.12; 95% confidence interval=1.30-7.87; p=0.01), resulting in similar results in a sensitive analysis. Additionally, median time to symptom onset was 70 days (range=56-119 days) in patients with pre-existing hypertension and 175 days (147 days-not available) in patients without pre-existing hypertension (p=0.004). No significant difference was noted in the range of fluctuations in systolic and diastolic blood pressure during treatment between patients with and without pre-existing hypertension.

Pre-existing hypertension is a risk factor for BV-induced severe hypertension in patients with breast cancer.