P3-9-4 - Importance of Blood Pressure Monitoring in Colorectal Cancer Patients Treated with Bevacizumab: the Current Situation

Abstract

Background: Hypertension associated with bevacizumab (Bev) is a well-known adverse drug reaction. However, we tend to overlook the symptom as other adverse drug events are induced by chemotherapy combined with Bev. In order to highlight the current issues in our hospital on blood pressure monitoring during Bev treatment we conducted this study.Methods: Thirty one colorectal cancer patients treated with Bev, from August 2007 to September 2011, at Fujita health university hospital were enrolled in this study. We retrospectively researched antihypertensive medication use and blood pressure change in the patients. The common terminology criteria for adverse events ver.3.0 (CTCAE) was used for adverse event classification.Results: Blood pressure elevation was observed in 14 (grade1 (G1); 45.1%), 6 (grade2 (G2); 19.3%) and 1 patient (grade 3 (G3); 3.2%). The number of Bev cycles administered was 2-22 (G1; median 3), 4-24 (G2; median 7.5) and 20 (G3). 5/6 patients (G2) showed G1 hypertension at early Bev treatment cycles then reached G2 with following treatment. 1 patient (G3) also showed G3 hypertension after G1/G2 at early cycles. Ca-blockers were prescribed to two (G2) and one patients (G3). In G3 case, Ca-blocker was added to ARB. 21 patients (67.7%) showed systolic blood pressure >140mmHg, which hypertension treatment guidelines recommend medication.Conclusions: The current issue in our hospital is that Bev-induced hypertension is not well controlled. It is necessary that the adverse drug reaction is controlled with medication as chemotherapy with Bev have resulted in good prognosis. Moreover, it is important to start hypertension control at G1 because G2/G3 is caused from uncontrolled hypertension during Bev treatment. Chemotherapy with Bev is given outpatients. It is considered that building a blood pressure monitoring system for outpatients and promoting patients education on home blood pressure measurement are urgent tasks.