ArticleInternational journal of clinical oncology2023
Impact of prior bevacizumab therapy on the incidence of ramucirumab-induced proteinuria in colorectal cancer: a multi-institutional cohort study.
Article in International journal of clinical oncology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 3 citations in OpenAlex.
- Clinical Outcomes of Second-Line FOLFIRI Plus Ramucirumab According to Prior Biologic Exposure in Metastatic Colorectal Cancer: A Retrospective Comparison of Prior Bevacizumab and Prior Anti-EGFR Cohorts.Journal of gastrointestinal cancer · 2026Article
- VEGF inhibitor-induced proteinuria: the role of hypertension and vascular endothelial dysfunction.Journal of pharmaceutical health care and sciences · 2026Review
- Effect of pretreatment vascular endothelial growth factor inhibitor use on the safety and efficacy of trifluridine/tipiracil plus bevacizumab in patients with metastatic colorectal cancer.International journal of clinical oncology · 2025Article
- Nephrotic syndrome after switching from irinotecan, S-1, and bevacizumab combination to trifluridine/tipiracil.CEN case reports · 2025Article
- Impact of Pre-treatment Proteinuria Progression on the Risk of Increased Proteinuria During Ramucirumab Therapy.Cancer diagnosis & prognosisArticle
- Comprehensive Analysis of Proteinuria and Nephrotic Syndrome Using the Japanese Adverse Drug Event Reporting Database.In vivo (Athens, Greece)Article
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Authors and funding
45 authors at 20 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe association between prior bevacizumab (BEV) therapy and ramucirumab (RAM)-induced proteinuria is not known. We aimed to investigate this association in patients with metastatic colorectal cancer (mCRC).
methodsmCRC patients who received folinic acid, fluorouracil, and irinotecan (FOLFIRI) plus RAM were divided into with and without prior BEV treatment groups. The cumulative incidence of grade 2-3 proteinuria and rate of RAM discontinuation within 6 months (6M) after RAM initiation were compared between the two groups.
resultsWe evaluated 245 patients. In the Fine-Gray subdistribution hazard model including prior BEV, age, sex, comorbidities, eGFR, proteinuria ≥ 2 + at baseline, and later line of RAM, prior BEV treatment contributed to proteinuria onset (P < 0.01). A shorter interval between final BEV and initial RAM increased the proteinuria risk; the adjusted odds ratios (95% confidence intervals) for the intervals of < 28 days, 28-55 days, and > 55 days (referring to prior BEV absence) were 2.60 (1.23-5.51), 1.51 (1.01-2.27), and 1.04 (0.76-1.44), respectively. The rate of RAM discontinuation for ≤ 6M due to anti-VEGF toxicities was significantly higher in the prior BEV treatment group compared with that in the no prior BEV treatment group (18% vs. 6%, P = 0.02). Second-line RAM discontinuation for ≤ 6M without progression resulted in shorter overall survival of 132 patients with prior BEV treatment (P < 0.01).
conclusionSequential FOLFIRI plus RAM after BEV failure, especially within 55 days, may exacerbate proteinuria. Its escalated anti-VEGF toxicity may negatively impact the overall survival.
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