1549P - Hypertension, proteinuria and overall survival in elderly cancer patients treated with bevacizumab

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anticancer agents
Complications/Toxicities of Treatment
Geriatric Oncology
Therapy
Biological Therapy
Presenter Vincent Launay-Vacher
Citation Annals of Oncology (2014) 25 (suppl_4): iv517-iv541. 10.1093/annonc/mdu356
Authors V. Launay-Vacher1, N. Janus1, I.L. Ray-Coquard2, J. Gligorov3, F. Selle4, P. Beuzeboc5, C. Daniel5, J. Spano6, J. Thery6, F. Goldwasser7, O. Mir7, J. Rey8, C. Jouannaud9, J. Morere10, S. Oudard11, F. Scotte12, M. Azizi13, R. Dorent14, G. Deray15
  • 1Service Icar, Nephrology, Pitié Salpétrière Hospital, 75651 - Paris/FR
  • 2Medical Oncology, Centre Léon Bérard, 69008 - Lyon/FR
  • 3Medical Oncology, Tenon Hospital, Paris/FR
  • 4Medical Oncology, Tenon Hospital, 75020 - Paris/FR
  • 5Medical Oncology Unit, Curie Institute, 75005 - Paris/FR
  • 6Medical Oncology, Pitié-Salpêtrière Hospital, Paris/FR
  • 7Medical Oncology, Cochin Hospital, 75014 - Paris/FR
  • 8Pharmacy, Institut jean Godinot, 51100 - REIMS/FR
  • 9Medical Oncology, Institut Godinot, 51000 - Reims/FR
  • 10Medical Oncology, Hopital Avicenne, FR-93009 - Bobigny/FR
  • 11Medical Oncology, Hopital European George Pompidou, 75015 - Paris/FR
  • 12Medical Oncology And Supportive Care Unit, Georges Pompidou European Hospital, Paris/FR
  • 13Cardiology, Hopital European George Pompidou, 75015 - Paris/FR
  • 14Cardiology, Tenon Hospital, Paris/FR
  • 15Nephrology, Pitié-Salpêtrière Hopital, 75013 - Paris/FR

Abstract

Aim

MARS is a multicentric, non-interventional, prospective study which first reported the high prevalence of both baseline and de novo hypertension (HTN) and proteinuria (Pu) in several sub group of cancer patients [Gligorov J et al. SABCS 2013; Ray-Coquard I et al. ASCO GI 2014; Ray-Coquard I et al. ASCO GU 2014; Goldwasser F et al. ECC 2013; Launay-Vacher V et al. ASCO 2013]. In this sub-group analysis, we focused on elderly cancer (EC) patients treated with bevacizumab.

Methods

MARS included 1'124 patients, all naïve of any previous anti-VEGF treatment. A First Renal Assessment was performed at baseline before the anti-VEGF was started with periodic follow-up for 1 year. Elderly was defined as age ≥65 years at inclusion. Univariate (UA) and multivariate analyses (MA) tested the associations of HTN and Pu, at baseline or de novo, with overall survival (OS) (pre-planned) in EC patients.

Results

845 patients treated with bevacizumab were included. Among them 226 were EC patients (colorectal 81, breast 78, ovarian 26, lung 22 …). At inclusion, HTA was statistically higher in EC patients (table), mean aMDRD was 79.6 ml/min/1.73m2 and 15.1% had aMDRD<60. De novo HTA; de novo Pu and Scr increase were not statistically more frequent in EC patients than in non-EC patients. In addition, renal function decreased by -4.1 ml/min/1.73m2/year and 16.2% had aMDRD<60 at the end of follow-up. Baseline and de novo HTN and Pu were not associated with reduced OS in EC patients in both UA and MA analyses. Table. Renovascular events in EC and non EC patients (NCI-CTC v4).

Renovascular events Patients ≥65 years Patients <65 years p-value
HTA at inclusion de novo 32.7% 20.4% 13.4% 16.6% p < 0.0001 p > 0.05
Pu at inclusion de novo 29.5% 71.9% 25.0% 65.1% p > 0.05 p > 0.05
SCr increase de novo 73.5% 76.3% p > 0.05

Conclusions

There were no differences in term of renovascular safety in EC patients treated with bevacizumab. Furthermore, HTN and Pu were not associated with OS in EC patients treated with bevacizumab.

Disclosure

V. Launay-Vacher: Bayer, Schering Pharma, Gilead Sciences, Janssen-Cilag, LEO Pharma, Amgen, Celgene, Boehringer Ingelheim, Daiichi Sankyo, Ipsen, Fresenius Biotec; N. Janus: Roche, Fresenius Medical Care, Pfizer; I.L. Ray-Coquard: Roche, Pharmamar; J. Gligorov: Roche, Teva; P. Beuzeboc: Roche; J. Spano: Cephalon, Merck Serono, MSD, LEO Pharma, GlaxoSmithKline, Amgen, Teva, Sanofi, Roche; J. Thery: Novartis; F. Goldwasser: Roche; O. Mir: Astra-Zeneca, Bayer, GSK, Novartis, Pfizer, Roche, Servier; J. Rey: B-Braun, Baxter, Fresenius, LEO Pharma, Merck Serono, Mundipharma, Sandoz, BMS, Amgen, Archimedes, Merck, Pfizer, Roche, Boehringer Ingelheim, Helsinn Healthcare; S. Oudard: Pfizer, Roche, Bayer, GSK, Novartis. All other authors have declared no conflicts of interest.