Deterioration of Glycemic Control Contributes to the Prevalence of Proteinuria among Bevacizumab-Treated Cancer Patients with Type 2 Diabetes Mellitus

• Published in: Biological & pharmaceutical bulletin Vol. 41; no. 11; pp. 1722 - 1726
• Main Authors: Sasaki, Akira, Obara, Mami, Kudo, Kenzo, Nihei, Satoru, Ishigaki, Yasushi, Chiba, Takeshi, Komatsu, Hideaki
• Format: Journal Article
• Language: English
• Published: Japan The Pharmaceutical Society of Japan 01.11.2018; Japan Science and Technology Agency
• Subjects: Aged; Antineoplastic Agents, Immunological - adverse effects; Antineoplastic Agents, Immunological - therapeutic use; Bevacizumab; Bevacizumab - adverse effects; Bevacizumab - therapeutic use; Blood Glucose - metabolism; Cancer; cancer patient; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Disease Progression; Female; Glucose; Glycated Hemoglobin A - metabolism; glycemic control; Hemoglobin; Humans; Immunotherapy; Male; Medical records; Middle Aged; Monoclonal antibodies; Neoplasms - blood; Neoplasms - drug therapy; Patients; Prevalence; Proteinuria; Proteinuria - blood; Proteinuria - etiology; Retrospective Studies; Targeted cancer therapy; type 2 diabetes; bevacizumab; cancer patient; type 2 diabetes; glycemic control; proteinuria
• ISSN: 0918-6158; 1347-5215; 1347-5215
• DOI: 10.1248/bpb.b18-00493

The objective of this study was to investigate whether improving glycemic control reduces the prevalence and progression of proteinuria among bevacizumab (BEV)-treated cancer patients with type 2 diabetes mellitus (DM). We retrospectively reviewed the medical records of 55 patients with type 2 DM who were treated with BEV between July 1 2011 and May 31 2018 at Iwate Medical University Hospital. The patients were classified based on changes in glycated hemoglobin (HbA1c) level during the 3 months following BEV administration into the “HbA1c elevated” group (+0.5% or above, n=24) and the “HbA1c non-elevated” group (indicating no change or decrease; n=31). At 3 months following BEV administration, the means of HbA1c and its change rate in the ‘HbA1c elevated’ group was significantly higher than that in the ‘HbA1c non-elevated’ group, and the prevalence of proteinuria in the ‘HbA1c elevated’ group was significantly higher than that in the ‘HbA1c non-elevated’ group. Additionally, our subjects were classified into the proteinuria group and non-proteinuria group. The mean HbA1c level in the proteinuria group was significantly higher than that in the non-proteinuria group at 3 months following BEV administration. Furthermore, the mean rates of change of HbA1c level in patients experiencing grades 1 and 2 proteinuria were +9.97±2.26 and +14.0±3.82%, respectively. These values were significantly higher than those of patients with no proteinuria (−2.15±1.96%). Our results suggest that deterioration of glycemic control contributes to the prevalence of proteinuria among BEV-treated cancer patients with type 2 DM.