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Clinical Trial
. 2008 Aug;26(4):393-7.
doi: 10.1007/s10637-008-9125-4. Epub 2008 Mar 12.

Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

J Tol  1 , A Cats, L Mol, M Koopman, M M E M Bos, J J M van der Hoeven, N F Antonini, J H J M van Krieken, C J A Punt
Affiliations
Clinical Trial

Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

J Tol et al. Invest New Drugs. 2008 Aug.

Abstract

Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n = 6), perforation (n = 8) or both (n = 4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.

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Figures

Fig. 1
Fig. 1
Gastric ulcer at endoscopy in patient 1
See this image and copyright information in PMC

References

    1. Weitz J, Koch M, Debus J, Hohler T, Galle PR, Buchler MW. Colorectal cancer. Lancet. 2005;365(9454):153–165. doi: 10.1016/S0140-6736(05)17706-X. - DOI - PubMed
    1. Punt CJ. New options and old dilemmas in the treatment of patients with advanced colorectal cancer. Ann Oncol. 2004;15(10):1453–1459. doi: 10.1093/annonc/mdh383. - DOI - PubMed
    1. Tol J, Punt CJA. Targeted therapy in advanced colorectal cancer, an update. Targeted Oncology. 2007;2(3):165–172. doi: 10.1007/s11523-007-0052-7. - DOI
    1. Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9(6):669–676. doi: 10.1038/nm0603-669. - DOI - PubMed
    1. Kabbinavar FF, Hambleton J, Mass RD, Hurwitz HI, Bergsland E, Sarkar S. Combined analysis of efficacy: the addition of bevacizumab to fluorouracil/leucovorin improves survival for patients with metastatic colorectal cancer. J Clin Oncol. 2005;23(16):3706–3712. doi: 10.1200/JCO.2005.00.232. - DOI - PubMed

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