Significant BP elevation predicts response to VEGF inhibitors

A significant increase in blood pressure (BP) appears predictive of therapeutic response to vascular endothelial growth factor (VEGF) inhibitors but does not limit treatment duration even in patients with severe elevations, suggests a study.

A total of 155 patients receiving treatment with VEGF inhibitors were analysed in this retrospective chart review. Time to progression (TTP) in those with or without a significant increase in BP (increase in systolic BP >20 mm Hg or >10 mm Hg in diastolic BP) was the primary endpoint.

Secondary endpoints included treatment interruption, therapy discontinuation due to documented adverse effect, and time to BP elevation. The authors performed subgroup analyses in patients receiving bevacizumab and oral tyrosine kinase inhibitors.

Of the patients, 93 (60 percent) developed a significant elevation in BP, with a median time to development of 47 days. Those with significant BP increases had a longer median TTP than patients without (8.1 vs 4.4 months; p=0.002).

No between-group differences were observed with regard to treatment interruption or discontinuation due to a documented adverse effect. Outcomes were also similar in patients receiving bevacizumab and oral tyrosine kinase inhibitors.

Analysis of the impact of BP elevation severity revealed the greater likelihood of treatment interruption among patients with severe BP elevation, but discontinuation rates were comparable across groups.

“VEGF inhibitors are known to cause hypertension,” the authors noted.