evacizumab-induced hypertension and proteinuria: a genome-wide study of more than 1000 patient

Author(s):Show less -

Quintanilha, Julia C. F. ^[1] ; Wang, Jin ^[2] ; Sibley, Alexander B. ^[3] ; Jiang, Chen ^[3] ; Etheridge, Amy S. ^[1] ; Shen, Fei ^[4] ; Jiang, Guanglong ^[5] ; Mulkey, Flora ^[6] ; Patel, Jai N. ^[7] ; Hertz, Daniel L. ^[8] ; Dees, Elizabeth Claire ^[9] ; McLeod, Howard L. ^[10] ; Bertagnolli, Monica ^[11] ; Rugo, Hope ^[12] ; Kindler, Hedy L. ^[13] ; Kelly, William Kevin ^[14] ; Ratain, Mark J. ^[13] ; Kroetz, Deanna L. ^[15] ; Owzar, Kouros ^{[16, 4]} ; Schneider, Bryan P. ^[4] ; Lin, Danyu ^[2] ; Innocenti, Federico ^[1]

Affiliation:Show less -

^[1] Univ N Carolina, Eshelman Sch Pharm, Chapel Hill, NC 27515 - USA

^[2] Univ N Carolina, Dept Biostat, Chapel Hill, NC 27515 - USA

^[3] Duke Univ, Med Ctr, Duke Canc Inst, Durham, NC - USA

^[4] Indiana Univ Sch Med, Dept Med, Indianapolis, IN 46202 - USA

^[5] Indiana Univ Purdue Univ, Dept BioHlth Informat, Indianapolis, IN 46202 - USA

^[6] Duke Univ, Alliance Stat & Data Ctr, Durham, NC - USA

^[7] Levine Canc Inst, Charlotte, NC - USA

^[8] Univ Michigan, Coll Pharm, 428 Church St, Ann Arbor, MI 48109 - USA

^[9] Univ N Carolina, Lineberger Comprehens Canc Ctr, Chapel Hill, NC 27515 - USA

^[10] H Lee Moffitt Canc Ctr & Res Inst, Dept Canc Epidemiol, Tampa, FL - USA

^[11] Dana Farber Canc Inst, Boston, MA 02115 - USA

^[12] Univ Calif San Francisco, Dept Med Hematol Oncol, San Francisco, CA 94143 - USA

^[13] Univ Chicago, Ctr Comprehens Canc, Chicago, IL 60637 - USA

^[14] Yale Sch Med, Dept Med Oncol, New Haven, CT - USA

^[15] Univ Calif San Francisco, Dept Bioengn & Therapeut Sci, San Francisco, CA 94143 - USA

^[16] Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC - USA

• Document type: Journal article
• Source: BRITISH JOURNAL OF CANCER; v. 126, n. 2 OCT 2021.
• Web of Science Citations: 1

Abstract

Background Hypertension and proteinuria are common bevacizumab-induced toxicities. No validated biomarkers are available for identifying patients at risk of these toxicities. Methods A genome-wide association study (GWAS) meta-analysis was performed in 1039 bevacizumab-treated patients of European ancestry in four clinical trials (CALGB 40502, 40503, 80303, 90401). Grade >= 2 hypertension and proteinuria were recorded (CTCAE v.3.0). Single-nucleotide polymorphism (SNP)-toxicity associations were determined using a cause-specific Cox model adjusting for age and sex. Results The most significant SNP associated with hypertension with concordant effect in three out of the four studies (p-value <0.05 for each study) was rs6770663 (A > G) in KCNAB1, with the G allele increasing the risk of hypertension (p-value = 4.16 x 10(-6)). The effect of the G allele was replicated in ECOG-ACRIN E5103 in 582 patients (p-value = 0.005). The meta-analysis of all five studies for rs6770663 led to p-value = 7.73 x 10(-8), close to genome-wide significance. The most significant SNP associated with proteinuria was rs339947 (C > A, between DNAH5 and TRIO), with the A allele increasing the risk of proteinuria (p-value = 1.58 x 10(-7)). Conclusions The results from the largest study of bevacizumab toxicity provide new markers of drug safety for further evaluations. SNP in KCNAB1 validated in an independent dataset provides evidence toward its clinical applicability to predict bevacizumab-induced hypertension. ClinicalTrials.gov Identifier: NCT00785291 (CALGB 40502); NCT00601900 (CALGB 40503); NCT00088894 (CALGB 80303) and NCT00110214 (CALGB 90401). (AU)

• FAPESP's process: 18/04491-2 - Genetic susceptibility to severe toxicities and toxic deaths among 1,626 cancer patients trated with bevacizumab: implications for treatment and personalized therapy
• Grantee: Júlia Coelho França Quintanilha
• Support Opportunities: Scholarships abroad - Research Internship - Doctorate