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Hypertension as a predictive biomarker in patients with advanced non-small-cell lung cancer treated with apatinib

Authors Fang SC, Huang W, Zhang YM, Zhang HT, Xie WP

Received 7 October 2018

Accepted for publication 7 January 2019

Published 1 February 2019 Volume 2019:12 Pages 985—992

DOI https://doi.org/10.2147/OTT.S189984

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Amy Norman

Peer reviewer comments 2

Editor who approved publication: Dr William Cho


Shen-Cun Fang,1,2 Wen Huang,2 Ying-Ming Zhang,1 Hai-Tao Zhang,1 Wei-Ping Xie2

1Department of Respiratory Medicine, Nanjing Chest Hospital, Nanjing, Jiangsu, China; 2Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China

Background: Hypertension (HTN) is a common adverse event of the vascular endothelial growth factor pathway inhibitor apatinib. This study was conducted to evaluate the association of apatinib-induced HTN with clinical outcomes in patients with advanced non-small-cell lung cancer (NSCLC).
Methods: We retrospectively analyzed 110 consecutive patients with advanced NSCLC who were treated with apatinib from August 2014 to January 2018. All patients were classified as normotensive or hypertensive based on blood pressure measurements after initiating therapy. Therapeutic response, progression-free survival (PFS), and overall survival (OS) were evaluated. Univariate and multivariate analyses were performed using the Cox proportional hazards method.
Results: A total of 46 patients (42%) were diagnosed with HTN. The median PFS for the hypertensive and normotensive groups were 5.6 months and 4.2 months, respectively (P=0.0027). The median OS times for the hypertensive and normotensive groups were 9.9 months and 7.8 months, respectively (P=0.005). Thirty percent of patients who experienced HTN showed partial response to apatinib as compared with 6.3% of non-hypertensive patients (P=0.002). HTN was independently associated with improved PFS and OS on both univariate and multivariate analyses.
Conclusion: Apatinib-induced HTN may be an inexpensive, valid, and easily measurable biomarker for apatinib antitumor efficacy in patients with advanced NSCLC.

Keywords: biomarker, hypertension, apatinib, non-small-cell lung cancer, clinical outcomes


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