A Case of Combined Use of an Angiotensin II Receptor Blocker and a Calcium Blocker to Prevent Recurrence of Proteinuria, Enabling Continued Bevacizumab Treatment

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Background. Proteinuria from bevacizumab treatment hinders continuation of treatment in many cases. Case. A 69-year-old female outpatient was given a diagnosis of cT4N2M0 stage IIIB primary lung adenocarcinoma. The patient underwent combination chemotherapy with carboplatin, paclitaxel, and bevacizumab. The treatment was effective, and continuation with bevacizumab alone was planned. However, at the conclusion of the second course of bevacizumab, elevated blood pressure and proteinuria were noted. Antihypertensive therapy with an angiotensin II receptor blocker (ARB) was initiated, but hypertension and proteinuria persisted and bevacizumab with additional calcium blocker treatment was discontinued. Two months after the termination of bevacizumab treatment, hypertension and proteinuria improved, and bevacizumab with antihypertensive therapy was reinitiated, with no subsequent recurrence. Conclusion. Proteinuria might have been prevented by the initiation of antihypertensive treatment before administration of bevacizumab.