ArticleKidney3602026
Bevacizumab-Associated Renal Adverse Events Signal Better Prognosis in Ovarian Cancer: A Double-Edged Vascular Endothelial Growth Factor Inhibition.
Article in Kidney360, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
key pointsRenal adverse events occurred in 34.7% of patients with bevacizumab-treated ovarian cancer, with hypertension being the most frequent manifestation. Pre-existing hypertension was the only independent risk factor for developing renal adverse events during bevacizumab therapy. The occurrence of renal adverse events was independently associated with improved overall survival, suggesting effective vascular endothelial growth factor pathway inhibition.
backgroundBevacizumab, a monoclonal antibody targeting vascular endothelial growth factor-A, is a cornerstone in ovarian cancer (OC). Bevacizumab is associated with renal adverse events, including hypertension (HTN), proteinuria, and AKI. The incidence, risk factors, and prognostic effect of these renal events remain poorly defined. This study aimed to determine the incidence, risk factors, and association with mortality of renal events in patients with OC treated with bevacizumab.
methodsWe conducted a retrospective single-center study including 147 patients with OC treated with bevacizumab between 2011 and 2023. Renal events were defined as new-onset or worsening HTN (grade ≥2), proteinuria (grade ≥2), and/or AKI, as per Common Terminology Criteria for Adverse Events v5.0 and Kidney Disease Improving Global Outcomes guidelines.
resultsOver a median follow-up of 52 months, 34.7% of patients developed a renal event, most commonly HTN (27.9%), followed by proteinuria (6.8%) and AKI (6.8%). Only a history of HTN was identified as an independent risk factor for renal event ( P = 0.0078). Importantly, patients with renal events had significantly longer survival compared with those who did not ( P = 0.0243). In the multivariate analysis, the occurrence of a renal event emerged as a protective factor against mortality.
conclusionsIn conclusion, renal events occurred in 34.7% of bevacizumab-treated patients. HTN was a risk factor for renal event, but renal events seemed to be a protective factor against mortality. Rather than signaling harm, their presence may reflect effective Vascular endothelial growth factor pathway inhibition and greater antitumor response. Routine monitoring and early nephrological management of HTN, proteinuria, and AKI are essential to optimize treatment continuity and outcomes.
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