Powikłania terapii antyangiogennej w leczeniu paliatywnym raka jelita grubego Original article

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Opublikowane: gru 2, 2016
DOI: https://doi.org/10.5604/01.3001.0009.5069
Słowa kluczowe:
bewacyzumab, rak jelita grubego, toksyczność leczenia, bezpieczeństwo leczenia

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Małgorzata Domagała-Haduch
Department of Systemic and Generalized Malignancies, Maria Sklodowska-Curie Memorial Institute of Oncology, Krakow Branch, Poland
Marek Jasiówka
Department of Gynecologic Oncology, Center of Oncology, Maria Sklodowska-Curie Memorial Institute of Oncology, Krakow Branch, Poland
Łukasz Nowak
Department of Anaesthesiology and Intensive Care, Maria Sklodowska-Curie Memorial Institute of Oncology, Krakow Branch, Poland
Ida Cedrych
Department of Systemic and Generalized Malignancies, Maria Sklodowska-Curie Memorial Institute of Oncology, Krakow Branch, Poland

Abstrakt

Wstęp: Bewacyzumab to lek antyangiogenny stosowany w wielu nowotworach litych. Jednym z nich jest gruczolakorak jelita grubego. Skuteczność i bezpieczeństwo bewacyzumabu zostało potwierdzone w licznych wieloośrodkowych badaniach klinicznych.


Cel: Analiza bezpieczeństwa leczenia bewacyzumabem chorych na raka jelita grubego w IV stopniu zaawansowania.


Materiał i metody: Analizie retrospektywnej poddano historie chorób 42 pacjentów z rozpoznaniem zaawansowanego raka jelita grubego leczonych w Klinice Nowotworów Układowych i Uogólnionych Centrum Onkologii – Instytut im. Marii Skłodowskiej-Curie, Oddział w Krakowie w latach 2007–2014.


Wyniki: Mediana czasu leczenia bewacyzumabem w badanej grupie wyniosła 6 miesięcy. Mediana czasu przeżycia wolnego od progresji choroby nowotworowej to 8,5 miesiąca. Działania niepożądane bewacyzumabu wystąpiły u 43% leczonych. Najczęstszymi z nich były krwawienia oraz nadciśnienie tętnicze. U 6 chorych (14,3%) leczenie antyangiogenne zostało przerwane z powodu ciężkich działań niepożądanych (incydenty zakrzepowo-zatorowe, krwotoki, perforacja przewodu pokarmowego).


Wnioski: Bewacyzumab może być bezpiecznie stosowany u pacjentów z przerzutowym rakiem jelita grubego, jeśli znajdują się oni pod ścisłą kontrolą onkologa i lekarza ogólnego.

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Domagała-Haduch M, Jasiówka M, Nowak Łukasz, Cedrych I. Powikłania terapii antyangiogennej w leczeniu paliatywnym raka jelita grubego. OncoReview [Internet]. 2 grudzień 2016 [cytowane 23 listopad 2024];6(4(24):199-04. Dostępne na: https://journalsmededu.pl/index.php/OncoReview/article/view/501
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Tom 6 Nr 4(24) (2016)
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Utwór dostępny jest na licencji Creative Commons Uznanie autorstwa – Użycie niekomercyjne 4.0 Międzynarodowe.

Copyright: © Medical Education sp. z o.o. This is an Open Access article distributed under the terms of the Attribution-NonCommercial 4.0 International (CC BY-NC 4.0). License (https://creativecommons.org/licenses/by-nc/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.

Address reprint requests to: Medical Education, Marcin Kuźma (marcin.kuzma@mededu.pl)

Bibliografia

1. Gimbrone Jr MA, Leapman SB, Cotran RS, Folkman J. Tumor dormancy in vivo by prevention of neovascularization. J Exp Med 1972; 136: 261-276.
2. Ferrara N. Vascular endothelial growth factor: molecular and biological aspects. Curr Top Microbiol Immunol 1999; 237: 1-30.
3. Ferrara N. VEGF-A: a critical regulator of blood vessel growth. Eur Cytokine Netw 2009; 20: 158-163.
4. Alitalo K, Tammela T, Petrova TV. Lymphangiogenesis in development and human disease. Nature 2005; 438: 946-953.
5. Berse B, Brown LF, Van de Water L et al. Vascular permeability factor (vascular endothelial growth factor) gene is expressed differentially in normal tissues, macrophages, and tumors. MolBiol Cell 1992; 3: 211-220.
6. Takahashi Y, Kitadai Y, Bucana CD et al. Expression of vascular endothelial growth factor and its receptor, KDR, correlates with vascularity, metastasis, and proliferation of human colon cancer. Cancer Res 1995; 55: 3964-3968.
7. Ellis LM, Takahashi Y, Liu W, Shaheen RM. Vascular endothelial growth factor in human colon cancer: biology and therapeutic implications Oncologist 2000; 5(Suppl 1): 11-15.
8. Ferrara N. Bevacizumab (Avastin), a humanized anti-VEGF monoclonal antibody for cancer therapy. Biochem Biophys Res Commun 2005; 333: 328-335.
9. Hurwitz H, Fehrenbacher L, Novotny V et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335-2342.
10. Giantonio BJ, Catalano PJ, Meropol NJ et al. Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results from the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 2007; 25: 1539-1544.
11. Wagner AD, Arnold D, Grothey AA et al. Anti-angiogenic therapies for metastatic colorectal cancer. Cochrane Database Syst Rev 2009; 3: CD005392.
12. Qi WX, Fu S, Zhang Q, Guo XM. Bevacizumab increases the risk of infections in cancer patients: A systematic review and pooled analysis of 41 randomized controlled trials. Crit Rev Oncol Hematol 2015; 94: 323-336.
13. Ranpura V, Hapani S, Wu S. Treatment-related mortality with bevacizumab in cancer patients: a meta analysis. JAMA 2011; 305: 487-494.
14. Ahmadizar F, Onland-Moret NC, de Boer A et al. Efficacy and safety assessment of the addition of bevacizumab to adjuvant therapy agents in cancer patients: a systematic review and meta-analysis of randomized controlled trials. PLoS One 2015; 10: e0136324.
15. Majid N, Ghissassi I, Mrabti H, Errihani H. Bevacizumab in clinical practice. Gulf J Oncolog 2015; 1: 33-37.
16. Pavlidis ET, Pavlidis TE. Role of bevacizumab in colorectal cancer growth and its adverse effects: a review. World J Gastroenterol 2013; 19: 5051-5060.
17. Hurwitz H, Saini S. Bevacizumab in the treatment of metastatic colorectal cancer: safety profile and management of adverse events. Semin Oncol 2006; 33(5 Suppl 10): S26-34.
18. Saltz LB, Clarke S, Diaz-Rubio E et al. Bevacizumab in combination with oxaliplatin-based chemotherapy as first-line therapy in metastatic colorectal cancer: a randomized phase III study. J Clin Oncol 2008; 26: 2013-2019.
19. Nalluri SR, Chu D., Keresztes R et al. Risk of venous thromboembolism with the angiogenesis inhibitor bevacizumab in cancer patients: a meta-analysis. JAMA 2008; 300(19): 2277-2285.
20. Scappaticci FA, Skillings JR, Holden SN et al. Arterial thromboembolic events in patients with metastatic carcinoma treated with chemotherapy and bevacizumab. J Natl Cancer Inst 2007; 99: 1232-1239.
21. Schutz FA, Je Y, Azzi GR et al. Bevacizumab increases the risk of arterial ischemia: a large study in cancer patients with a focus on different subgroup outcomes. Ann Oncol 2011; 22: 1404-1412.
22. Kozloff M, Yood MU, Berlin J et al. Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study. Oncologist 2009; 14: 862-870.
23. Van Cutsem E, Rivera F, Berry S et al. Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol 2009; 20: 1842-1847.
24. Nazer B, Humphreys BD, Moslehi J. Effects of novel angiogenesis inhibitors for the treatment of cancer on the cardiovascular system: focus on hypertension. Circulation 2011; 124: 1687-1691.
25. Economopoulou P, Kotsakis A, Kapiris I, Kentepozidis N. Cancer therapy and cardiovascular risk: focus on bevacizumab. Cancer Manag Res 2015; 7: 133-143.
26. Cai J, Ma H, Huang F et al. Correlation of bevacizumab-induced hypertension and outcomes of metastatic colorectal cancer patients treated with bevacizumab: a systematic review and meta-analysis. World J Surg Oncol 2013; 11: 306.
27. Feliu J, Salud A, Safont MJ et al. Correlation of hypertension and proteinuria with outcome in elderly bevacizumab-treated patients with metastatic colorectal cancer. PLoS One. 2015; 10(1): e0116527.
28. Curigliano G, Cardinale D, Suter T et al. Cardiovascular toxicity induced by chemotherapy, targeted agents and radiotherapy: ESMO Clinical Practice Guidelines. Ann Oncol 2012; (23 suppl 7): 155-166.
29. Lafayette RA, McCall B, Li N et al. Incidence and relevance of proteinuria in bevacizumab-treated patients: pooled analysis from randomized controlled trials. Am J Nephrol 2014; 40: 75-83.