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Review

Bevacizumab (Antineoplastic)

No authors listed
In: LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012.
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Review

Bevacizumab (Antineoplastic)

No authors listed.
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Excerpt

Bevacizumab is a humanized monoclonal antibody to human vascular endothelial growth factor (VEGF) and an anti-angiogenesis agent used in the therapy of colorectal, ovarian, renal and brain cancers. Bevacizumab has not been linked to serum enzyme elevations during therapy or to idiosyncratic acute liver injury. Bevacizumab may be partially protective against the vascular hepatic damage caused by other chemotherapeutic agents.

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References

    1. Zimmerman HJ. Drugs used to treat rheumatic and musculospastic disease. In, Zimmerman HJ. Hepatotoxicity: the adverse effects of drugs and other chemicals on the liver. 2nd ed. Philadelphia: Lippincott, 1999, pp. 517-54.(Expert review of hepatotoxicity published in 1999; well before the availability of most monoclonal antibody therapies).
    1. Reuben A. Hepatotoxicity of immunosuppressive drugs. In, Kaplowitz N, DeLeve LD, eds. Drug-induced liver disease. 3rd ed. Amsterdam: Elsevier, 2013, pp. 569-91(Review of hepatotoxicity of immunosuppressive agents mentions that "the biological immunosuppressants are largely free from hepatotoxicity, with the exception of the TNF alpha antagonists").
    1. Chabner BA, Barnes J, Neal J, Olson E, Mujagiv H, Sequist L, Wilson W, et al. Targeted therapies: tyrosine kinase inhibitors, monoclonal antibodies, and cytokines. In, Brunton LL, Chabner BA, Knollman BC, eds. Goodman & Gilman's the pharmacological basis of therapeutics. 12th ed. New York: McGraw-Hill, 2011, pp. 1731-53.(Textbook of pharmacology and therapeutics).
    1. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W, Berlin J, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 2004; 350: 2335-42. (Among 813 patients with metastatic colorectal cancer treated with irinotecan, fluorouracil and leucovorin [FOLFIRI] with or without bevacizumab, patient survival was longer with bevacizumab, but adverse events were similar in the two groups; no mention of ALT elevations or hepatotoxicity). - PubMed
    1. Two new drugs for colon cancer. Med Lett Drugs Ther 2004; 46 (1184):46-8. (Concise review of mechanism of action, clinical efficacy, and cost of bevacizumab and cetuximab, two antineoplastic monoclonal antibodies, shortly after their approval in the US; adverse effects of bevacizumab include gastrointestinal bleeding or perforation, hypertension, pulmonary hemorrhage, thrombosis and asthenia; no mention of hepatotoxicity). - PubMed

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