While bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), can be effective in fighting tumor growth, a common side effect is bevacizumab-induced hypertension. At least three theories exist as to why patients develop hypertension. Understanding the pathology of hypertension is critical because, according to a study from Athens Medical School, investigations using bevacizumab exist for almost all types of solid tumors. However, solid mechanistic support of any theory has not yet been obtained, making it a somewhat risky treatment.
Despite the risk for hypertension, researchers continue to apply bevacizumab in the context of first-line and adjuvant treatments due to its efficacy in stopping cancer progression. Recently, a group from Norton Healthcare and the University of Louisville School of Medicine in Kentucky identified how “Targeted Intraarterial Anti-VEGF Therapy for Medically Refractory Radiation Necrosis in the Brain” mitigates some side effects due to systemic injection of bevacizumab.
Eight and a half months after treatment, both patients showed significant and durable responses. Headaches and cerebral edema were reduced, and motor strength was highly improved. Importantly, no signs of hypertension were reported by the authors.
Due to the safety of injection and beneficial response, the authors stated the efficacy of intraarterial bevacizumab for treatment. Due to the improvements over intravenously delivered bevacizumab — higher local dose, lower systemic dose, decreased toxicity, and lower cost — it seems intraarterial bevacizumab may be safe for some patients without inducing hypertension.