QIM20-124: Retrospective Evaluation of VEGF Inhibitor-Associated Hypertension at a Community Cancer Center

Authors: Jasmin Eugene PharmD1, Carli Nesheiwat PharmD, BCOP1, and Scott Overmier PharmD, BCPS1
View More View Less
  • 1 Our Lady of the Lake Regional Medical Center, Baton Rouge, LA

Background: Vascular endothelial growth factor (VEGF) inhibitors disrupt angiogenesis and slow tumor growth but have a clinically significant side effect of hypertension. Between 9-59% of patients may develop hypertension induced VEGF inhibitors. Medication labeling for VEGF inhibitors recommend standard pharmacologic treatment of hypertension, interruption of chemotherapy, or discontinuation during hypertensive crisis. Actively controlling patients’ blood pressure allows them to receive the optimal dose of antineoplastic agent without the complication of hypertension. The purpose of this study is to evaluate an institution’s practices of monitoring, identifying, and treating patients’ VEGF inhibitor induced hypertension. Methods: This retrospective, single-center, chart review assessed patients’ blood pressure measurements who received bevacizumab, ramucirumab, sorafenib, regorafenib, sunitinib, or pazopanib. Patients were excluded if they were less than 18, received VEGF inhibitors for non-oncologic indications, or were lost to follow up. The primary objectives were to assess treatment of VEGF inhibitor-associated hypertension at the institution and the time to first intervention. Treatment was defined as an increase or addition of an antihypertensive or an adjustment in dose or discontinuation of VEGF inhibitor. Secondary objectives were to assess the incidence of VEGF inhibitor-associated hypertension, evaluate time to development or exacerbation of hypertension, assess the time to second pharmacologic intervention, and to assess the achievement of goal blood pressure. Results: Ninety-three patients (59.6%) developed hypertension and 31 patients (33.3%) were treated for hypertension. The average time to first pharmacologic intervention was 57.8 days. The most common antihypertensive used was a calcium channel blocker. The average time to development or exacerbation of hypertension was 68.5 days. The time to second pharmacologic intervention was 132.3 days. Of the patients treated for hypertension, 67.7% of patients achieved blood pressure goal. One patient experienced hypertensive crisis requiring hospital admission. Three patients discontinued therapy due to hypertensive crisis. Conclusion: The incidence of VEGF inhibitor-associated hypertension was slightly higher than reported incidence of VEGF inhibitors. Of the 93 patients who developed hypertension, 31 patients were treated for hypertension and 67.7% achieved blood pressure goal.

Corresponding Author: Jasmin Eugene, PharmD
All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 358 85 5
PDF Downloads 473 70 2
EPUB Downloads 0 0 0