Association of Hypertension and Proteinuria with Overall Survival in Solid-Tumor Patients Treated with Anti-Vegf Drugs in the MARS Study.

2548 Background: MARS is a multicentric, noninterventional, prospective study which first reported the high prevalence of both baseline and de novo hypertension (HTN) and proteinuria (Pu) in patients receiving bevacizumab (Bev) or sunitinib (Su) (Gligorov J et al. SABCS 2013; Ray-Coquard I et al. ASCO GI 2014; Ray-Coquard I et al. ASCO GU 2014; Goldwasser F et al. ECC 2013; Launay-Vacher V et al. ASCO 2013). Methods: It included 1,124 patients, all naive of any previous anti-VEGF treatment. A First Renal Assessment was performed before the anti-VEGF was started with periodic follow-up for 1 year (Renal Follow-up Plan). Univariate (UA) and multivariate analyses (MA) tested the associations of HTN and Pu, at baseline or de novo, with overall survival (OS) (pre-planned). Results: De novo Pu was not associated with reduced OS, in any group. De novo Pu was a statistically significant prognostic factor for better OS in Bev-treated CRC, both in UA and MA. Baseline Pu was prognostic of reduced OS in Bev-treated LC, in UA but not in MA. HTN, either at baseline or de novo, was not found to be associated with OS, in any group. Conclusions: HTN was not associated with OS in our study, even in RCC Su-treated patients. De novo Pu, determined with a urinary dipstick, which is neither invasive nor costly, could be an easily accessible prognostic factor of better OS in Bev-treated CRC. Bev treatment in LC patients experiencing de novo Pu should be discussed since it can be prognostic of poorer OS. UA MA BC + Bev (n=402) CRC + Bev (n=195) RCC + Su (n=112) LC + Bev (n=101) OC + Bev (n=79) BC + Bev (n=402) CRC + Bev (n=195) RCC + Su (n=112) LC + Bev (n=101) OC + Bev (n=79) Baseline HTN NS NS NS NS NS NS NS NS NS NS Pu NS NS NS p=0.03 HR=2.46 [1.09-5.54] NS NS NS NS NS NS De novo HTN NS NS NS NS NS NS NS NS NS NS Pu NS p=0.004 HR=0.31 [0.14-0.67] NS NS NS NS p=0.01 HR=0.57 [0.39-0.83] NS NS NS Abbreviations: HTN: hypertension; Pu: proteinuria; BC: breast; CRC: colorectal; LC: lung; OC: ovarian cancers; RCC: renal cell carcinoma; Bev: bevacizumab; Su: sunitinib; NS: not significant (p>0.05).