| アブストラクト | BACKGROUND: Pegylated liposomal doxorubicin (PLD) and bevacizumab are commonly used to treat platinum-resistant ovarian cancer. While both agents are associated with cardiovascular toxicities, their combined impact on cardiotoxicity in real-world settings is not well defined. This study investigates whether co-administration of PLD and bevacizumab increases the risk of cardiovascular adverse events compared to PLD alone. METHODS: A retrospective cohort study was conducted using the TriNetX Analytics Network Database. Patients treated with PLD and bevacizumab were matched 1:1 to those receiving PLD alone using propensity score matching. Cardiovascular outcomes, including heart failure, cardiomyopathy, hypertension, and venous thromboembolism, were assessed over two years. Replication was performed using VigiBase, the World Health Organization's global adverse drug reaction database, through disproportionality analysis. RESULTS: Among 1,194 matched patients in each group, combination therapy was associated with increased risks of heart failure or cardiomyopathy (OR 1.42, 95% CI 1.07-1.88, P = 0.015), hypertension (OR 1.80, 95% CI 1.36-2.38, P < 0.001), venous thromboembolism (OR 1.23, 95% CI 1.02-1.49, P = 0.029), and all-cause mortality (OR 1.26, 95% CI 1.07-1.48, P = 0.005). VigiBase analysis confirmed disproportionate reporting of hypertension (ROR 6.05, 95% CI 4.61-7.94), heart failure (ROR 1.75, 95% CI 1.23-2.47), and pericardial disorders (ROR 3.67, 95% CI 1.61-8.38) in patients receiving combination therapy. CONCLUSIONS: Combined PLD and bevacizumab therapy was associated with increased risk of cardiotoxicity compared to PLD alone. These findings emphasize the need for proactive cardiovascular monitoring in patients undergoing this combination treatment. Prospective studies are warranted to further elucidate the underlying mechanisms and to refine clinical management strategies. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s40959-025-00351-4. |
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| 投稿者 | Hoeger, Christopher W; Choudhary, Arrush; Diaz, Andrea Nathalie Rosas; Pinto, Theresa; Smalec, Sarah; Doladille, Charles; Wadhera, Rishi; Shea, Meghan; Khadke, Sumanth; Salem, Joe-Elie; Ganatra, Sarju; Asnani, Aarti |
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| 組織名 | Division of Cardiovascular Medicine, Beth Israel Deaconess Medical Center,;Harvard Medical School, Boston, MA, USA.;Montefiore-Einstein Center for Heart and Vascular Care, Montefiore Medical;Center, Albert Einstein College of Medicine, Bronx, NY, United States of America.;Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical;School, Boston, MA, USA.;Department of Pharmacy, Beth Israel Deaconess Medical Center, Harvard Medical;Normandie University, UNICAEN, INSERM U1086 ANTICIPE, Caen, France.;PICARO Cardio-Oncology Program, Department of Pharmacology, CHU de;Caen-Normandie, Caen, France.;Division of Medical Oncology, Beth Israel Deaconess Medical Center, Harvard;Medical School, Boston, MA, USA.;Department of Cardiovascular Medicine, Lahey Hospital & Medical Center,;Burlington, MA, USA.;Assistance Publique Hopitaux de Paris, Pitie-Salpetriere Hospital, INSERm,;Sorbonne University, Paris, CIC-1901, France.;Harvard Medical School, Boston, MA, USA. aasnani@bidmc.harvard.edu.;3 Blackfan Circle, CLS-911, Boston, MA, 02115, USA. aasnani@bidmc.harvard.edu. |
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