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Research Paper|Volume 10, Issue 6|pp 1424—1441

Usefulness of bevacizumab-induced hypertension in patients with metastatic colorectal cancer: an updated meta-analysis

Chun-Jing Zhang1, Shu-Ying Zhang2, Chun-Di Zhang3, Chun-Rong Lin4, Xue-Yan Li4, Qiu-Yan Li1, Hai-Tao Yu5
  • 1Department of Biochemistry, Institute of Medical Technology, Qiqihar Medical University, Qiqihar, Heilongjiang, China
  • 2Division of Hematology, The Second Affiliated Hospital of Qiqihar Medical University, Qiqihar, Heilongjiang, China
  • 3Department of Foreign Languages, Qiqihar Medical University, Qiqihar, Heilongjiang, China
  • 4Institute of Polygenic Diseases, School of Medicine and Pharmacy, Qiqihar Medical University, Qiqihar, Heilongjiang, China
  • 5Department of Cell Biology and Medical Genetics, Basic Medical College, Qiqihar Medical University, Qiqihar, Heilongjiang, China
Received: April 12, 2018Accepted: June 10, 2018Published: June 21, 2018
https://doi.org/10.18632/aging.101478

Copyright: © 2018 Zhang et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Abstract

We tested the hypothesis that bevacizumab-induced hypertension may be a useful predictor for objective response rate, progression-free and overall survival in patients with metastatic colorectal cancer via a comprehensive meta-analysis. Search process, article selection and data extraction were independently performed by two investigators. Statistical analyses were conducted using the STATA/SE software. Fourteen independent studies and 2292 study subjects were synthesized. Overall relative risk of objective response rate for bevacizumab-induced hypertension was 2.03 (95% confidence interval [CI]: 1.18-3.48, p=0.01), with significant heterogeneity and publication bias, whereas unbiased estimate was nonsignificant after considering potentially missing studies. Overall hazard ratio for progression-free survival was 0.58 (95% CI: 0.43-0.77, p<0.001), with significant heterogeneity and publication bias, and unbiased estimate was significant (hazard ratio: 0.52, 95% CI: 0.41-0.66, p<0.001). Overall hazard ratio for overall survival was 0.51 (95% CI: 0.39-0.65, p<0.001), and this estimate was not likely confounded by heterogeneity or publication bias. Subgroup and meta-regression analyses suggested that hypertension grade of controls, sample size, age and gender were possible causes of heterogeneity. Taken together, our findings indicate that bevacizumab-induced hypertension can predict progress-free survival and overall survival in patients with metastatic colorectal cancer, whereas its prediction for objective response rate was nonsignificant.