(088) Evaluation of Bevacizumab-Related Hypertension and Proteinuria and Treatment Response in Gynecologic Cancer (Top Ten Poster)

Poster Abstract: Background/Rationale:
Bevacizumab is a medication used to treat many solid tumors including ovarian, endometrial, and cervical malignancies. It binds to vascular endothelial growth factor (VEGF) and prevents binding to the VEGF receptors, which inhibits endothelial cell proliferation and angiogenesis. Bevacizumab has a high incidence of adverse events, including hypertension and proteinuria. It is hypothesized that the mechanism of these adverse events is related to the mechanism of action, and some previous trials have demonstrated a correlation between hypertension and proteinuria with bevacizumab efficacy in other cancers. In metastatic colorectal cancer (mCRC), hypertension and proteinuria have shown correlation with higher rates of overall response, with mixed results for PFS and OS. In glioblastoma (GBM), hypertension and proteinuria showed correlation with prolonged progression-free survival. Available data regarding proteinuria or hypertension as a biomarker of response in gynecologic malignancies treated with bevacizumab is limited. This study aims to compare disease outcomes in patients receiving bevacizumab for gynecologic malignancies who experience proteinuria and/or hypertension versus patients who receive bevacizumab but do not experience these toxicities in the same population.
Objective(s):
The primary objective is to determine the progression free survival in patients receiving bevacizumab compared between those who develop hypertension and/or proteinuria and those who do not develop these toxicities. Secondary objectives to be analyzed include comparison of objective response rate, disease control rate, overall survival, and time to normalization of CA125 between groups. A multivariate and univariate analysis will also be run to determine predictive factors of response to bevacizumab therapy.

Methods:
This single-health system, retrospective, observational study will be conducted at UC Health, including patients at the University of Cincinnati Medical Center and West Chester hospitals. Participants to be included must be at least 18 years of age with pathologically confirmed gynecologic malignancy who have received at least two cycles of bevacizumab. Exclusion criteria include pregnancy, incarceration, receipt of hemodialysis during treatment, significant proteinuria at baseline, and uncontrolled hypertension at baseline. Eligible patient records to be included will be those available through UC Health from August 2014– August 2023.

Results:
Results pending.
Conclusions/

Discussion:
The aim of this proposed study is to investigate the relationship between development of bevacizumab-related hypertension and/or proteinuria and treatment response in gynecologic malignancies. Results to be reported at the 2024 Hematology/Oncology Annual Conference.

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2. NCCN Guidelines Cervical Cancer 1.2023. National Comprehensive Cancer Network. Revised April 2023.
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