抄録
The aim of this study was to clarify the influence of renin-angiotensin (RA) system blockers on the anti-cancer effect of chemotherapy with bevacizumab and its adverse effects.Twenty-six patients treated for metastatic colorectal cancer at Kyoto University Hospital between August 2007 and July 2008 were assessed.All of the patients received bevacizumab plus mFOLFOX 6 or FOLFIRI,and were divided into a control group (23 patients) and an RA system blocker group (3 patients).
Regarding background factors,which included chemotherapy doses,the only significant difference between the groups was with respect to age.However,hypertension grades in the RA system blocker group were significantly higher than those in the control group,and RA system blockers had no significant antihypertensive effect.There was no severe proteinuria in either group.As for anti-cancer effects,in the control group,6 patients exhibited a partial response and in 16 patients,the disease was stable.In only one patient was the disease progressive.On the other hand,the disease was progressive in all patients in the RA system blocker group.
These findings indicate that anti-hypertensive agents which provide better hypertension control than RA system blockers may be necessary as first line medication for the management of bevacizumab-induced hypertension.Although RA system blockers are useful antihypertension agents,they might not be able to control bevacizumab-induced hypertension and proteinuria,and could reduce the anti-cancer effect of bevacizumab.
