Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?

ObjectiveAlkylating agents and bevacizumab are both first-line chemotherapeutic options for the treatment of glioblastoma; however, their mechanisms of action differ substantially. This study aimed to compare the safety profiles of these two drug classes in the treatment of glioblastoma to inform cl...

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Main Authors: Zhizhao Qu, Jiajia Zhao, Liu Yang, Yuanwei Fu, Rui Bai, Jinchuan Li, Hongqin Wang
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1595642/full
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author Zhizhao Qu
Zhizhao Qu
Jiajia Zhao
Liu Yang
Yuanwei Fu
Rui Bai
Jinchuan Li
Hongqin Wang
author_facet Zhizhao Qu
Zhizhao Qu
Jiajia Zhao
Liu Yang
Yuanwei Fu
Rui Bai
Jinchuan Li
Hongqin Wang
author_sort Zhizhao Qu
collection DOAJ
description ObjectiveAlkylating agents and bevacizumab are both first-line chemotherapeutic options for the treatment of glioblastoma; however, their mechanisms of action differ substantially. This study aimed to compare the safety profiles of these two drug classes in the treatment of glioblastoma to inform clinical decision-making.MethodsAdverse events reported between the first quarter of 2004 and the fourth quarter of 2023 were analyzed using data from the FDA Adverse Event Reporting System (FAERS) database. Disproportionality analysis was employed to assess and compare the AE signals associated with bevacizumab and alkylating agents.ResultsIn the context of glioblastoma treatment, 3,323 adverse reports were associated with bevacizumab, 5,283 with temozolomide, and 427 with lomustine. The most frequently reported AEs for bevacizumab were fatigue (n = 276), hypertension (n = 220), and headache (n = 199). Compared to temozolomide, bevacizumab was more strongly associated with “vascular disorders,” “renal and urinary disorders,” and “hypertension.” Notably, bevacizumab appeared to offer a potential safety advantage with respect to hematological adverse events.ConclusionOur analysis indicates that bevacizumab exhibits a distinct safety profile compared to alkylating agents, particularly demonstrating a lower incidence of hematological adverse events. Further prospective studies are warranted to validate these findings and to elucidate the underlying mechanisms responsible for the observed adverse events.
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spelling doaj-art-6e81c9d9cfaa405f88b9bee074212bfb2025-08-20T02:31:30ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-05-011610.3389/fphar.2025.15956421595642Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?Zhizhao Qu0Zhizhao Qu1Jiajia Zhao2Liu Yang3Yuanwei Fu4Rui Bai5Jinchuan Li6Hongqin Wang7Department of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaGraduate School, Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurology, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurosurgery, Second Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaDepartment of Neurosurgery, First Hospital of Shanxi Medical University, Taiyuan, Shanxi, ChinaObjectiveAlkylating agents and bevacizumab are both first-line chemotherapeutic options for the treatment of glioblastoma; however, their mechanisms of action differ substantially. This study aimed to compare the safety profiles of these two drug classes in the treatment of glioblastoma to inform clinical decision-making.MethodsAdverse events reported between the first quarter of 2004 and the fourth quarter of 2023 were analyzed using data from the FDA Adverse Event Reporting System (FAERS) database. Disproportionality analysis was employed to assess and compare the AE signals associated with bevacizumab and alkylating agents.ResultsIn the context of glioblastoma treatment, 3,323 adverse reports were associated with bevacizumab, 5,283 with temozolomide, and 427 with lomustine. The most frequently reported AEs for bevacizumab were fatigue (n = 276), hypertension (n = 220), and headache (n = 199). Compared to temozolomide, bevacizumab was more strongly associated with “vascular disorders,” “renal and urinary disorders,” and “hypertension.” Notably, bevacizumab appeared to offer a potential safety advantage with respect to hematological adverse events.ConclusionOur analysis indicates that bevacizumab exhibits a distinct safety profile compared to alkylating agents, particularly demonstrating a lower incidence of hematological adverse events. Further prospective studies are warranted to validate these findings and to elucidate the underlying mechanisms responsible for the observed adverse events.https://www.frontiersin.org/articles/10.3389/fphar.2025.1595642/fulltemozolomidebevacizumabalkylating agentglioblastomaFAERSsafety profile
spellingShingle Zhizhao Qu
Zhizhao Qu
Jiajia Zhao
Liu Yang
Yuanwei Fu
Rui Bai
Jinchuan Li
Hongqin Wang
Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
Frontiers in Pharmacology
temozolomide
bevacizumab
alkylating agent
glioblastoma
FAERS
safety profile
title Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
title_full Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
title_fullStr Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
title_full_unstemmed Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
title_short Comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management – What have we learned recently?
title_sort comparative safety analysis of bevacizumab and alkylating agent in glioblastoma management what have we learned recently
topic temozolomide
bevacizumab
alkylating agent
glioblastoma
FAERS
safety profile
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1595642/full
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