Key result
Adding bevacizumab to CHOP chemotherapy is linked to increased cardiac toxicity in peripheral T-cell lymphoma.
Why the study?
Peripheral T cell lymphoma has poor outcomes after CHOP treatment and VEGF is overexpressed, suggesting antiangiogenesis as a therapeutic option; cardiac toxicity of bevacizumab combined with CHOP needed evaluation.
Does bevacizumab in combination with CHOP chemotherapy cause cardiac toxicity in patients with peripheral T cell lymphoma?
Does bevacizumab in combination with CHOP chemotherapy cause cardiac toxicity in patients with peripheral T cell lymphoma?
This study evaluates the risk of cardiac toxicity when bevacizumab is added to CHOP chemotherapy for peripheral T cell lymphoma.
May warrant cardiac monitoring with bevacizumab-CHOP in PTCL; hypothesis-generating and should not change practice without prospective validation.
Most patients with peripheral T Cell lymphoma (PTCL) relapse after initial anthracycline based (CHOP) treatment with a 5-year overall survival (OS) of > 30 – 50% [1]. Vascular endothelial growth factor (VEGF-A) is strongly expressed in PTCL and serum concentration of VEGF is an independent predictor of poor outcome [1 – 3]. Gene expression profiling studies in PTCL have also reported that VEGF is significantly over expressed in PTCL supporting the concept that antiangiogenesis may be a therapeutic option [4]. Bevacizumab (Avastin), an anti-angiogenic agent, is a humanized monoclonal antibody directed against VEGFA and FDA approved for lung, colorectal, breast and brain cancers. E2404 study evaluated the combination of bevacizumab and CHOP (A-CHOP) followed by maintenance bevacizumab in patients with newly diagnosed PTCL. Due to the reported 3.8% incidence of cardiac failure associated with bevacizumab in patients with metastatic breast cancer (MBC) previously exposed to anthracyclines (Avastin package insert), cardiac function (ejection fraction) was prospectively monitored by echocardiography. We report on increased cardiac toxicity with A-CHOP observed in E2404. Results of the overall study will be reported in a separate publication.
No takes yet. Share an insight, caveat, or question.
Advani et al. (2011) studied Peripheral T cell lymphoma (PTCL). Bevacizumab and CHOP (A-CHOP) was evaluated on Cardiac toxicity. The combination of bevacizumab and CHOP chemotherapy (A-CHOP) was associated with increased cardiac toxicity in patients with newly diagnosed peripheral T cell lymphoma.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: