Hypertension secondary to anti-angiogenic therapy: experience with bevacizumab.

BACKGROUND Hypertension (HT) is a common complication of anti-angiogenic therapy. Its incidence, treatment and complications are undefined. PATIENTS AND METHODS Retrospective review of patients treated with bevacizumab (BV) from 2003-5. Common toxicity criteria (CTC) for adverse events version 3.0 were used. RESULTS Fifty-five out of the 154 patients treated with BV (35%) experienced HT. Eleven (20%) developed a new onset HT and 44 (80%) experienced an exacerbation of pre-existing HT. HT developed after a median of 11 weeks at a median BV dose of 10 mg/kg. HT severity was grade 1 (n =1), grade 2 (n=29) or grade 3 (n=22); 3 experienced hypertensive complications. HT was controlled in 47 (85%); BV was discontinued in 3. The angiotensin-converting enzyme inhibitor (ACE-I), quinapril was commonly used and resulted in better HT control than ACE-II, calcium channel or beta antagonists. CONCLUSION HT associated with bevacizumab therapy is a manageable toxicity with the use of ACE-I.