The safety of bevazicumab for the treatment of ovarian cancer

Abstract

The safety profile of bevacizumab (BV) remains a challenging issue, in particular its role in fragile OC patients. Areas covered: In this literature review, we have analyzed safety data from Phase III trials evaluating the combination of BV plus standard chemotherapy in advanced or recurrent OC patients. In particular, our review aimed at clarifying the impact of the drug on fragile patients, and the correlation between BV and postoperative complications after cytoreductive surgery. Expert opinion: The addition of BV to standard chemotherapy regimens may cause unexpected side effects such as hypertension or proteinuria in up to 10% of women receiving the drug. BV administration is not associated with increase postoperative complications after cytoreductive surgery. Artero-venous thromboembolism and gastrointestinal perforation/fistula occurring in around 3% of OC patients treated with BV represent life-threatening events always requiring drug suspension. A closer monitoring is required in selected groups of women including: women with inflammatory bowel disease, or uncontrolled hypertension. Age itself is not a major contraindication, but older women should be carefully evaluated prior to start the drug. Finally, BV maintenance therapy should not be prematurely stopped due to minor events, since drug suspension may reduce survival.

Keywords: Bevacizumab; complications; cytoreductive surgery; elderly patients; fragility; gastrointestinal disease; gynecological cancer; ovarian cancer; recurrent disease.