title: Surgical wound healing complications in metastatic colorectal cancer patients treated with bevacizumab.
abstract: BACKGROUND
  Bevacizumab (Avastin; rhuMab VEGF), a humanized monoclonal antibody against vascular endothelial growth factor (VEGF), significantly prolongs survival when added to intravenous 5-fluorouracil-based chemotherapy in first-line metastatic colorectal cancer (CRC) treatment. Because antiangiogenic agents might inhibit wound healing, we assessed postoperative wound healing complications in two randomized trials of 5 mg/kg bevacizumab in CRC treatment.
  
  
  METHODS
  We assessed the wound healing complications in patients who: (1) underwent cancer surgery 28-60 days before study treatment and (2) underwent major surgery during study treatment. Cases were reviewed for wound healing complications occurring < or = 60 days after surgery.
  
  
  RESULTS
  With cancer surgery 28-60 days before study treatment, wound healing complications occurred in 3/230 (1.3%) bevacizumab-treated patients and 1/194 (0.5%) control patients. With major surgery during study treatment, 10/75 bevacizumab-treated patients (13%) and 1/29 control patients (3.4%) had wound healing complications. Bevacizumab-treated patients experienced complications with surgery < or = 30 and 31-60 days after the last dose.
  
  
  CONCLUSIONS
  Bevacizumab administered in combination with 5-fluorouracil/leucovorin-based chemotherapy 28-60 days after primary cancer surgery caused no increased risk of wound healing complications compared with chemotherapy alone. While wound healing complications were increased in patients who had major surgery during bevacizumab therapy, the majority of bevacizumab-treated patients experienced no complications.
authors.affiliation: Genentech, Inc., South San Francisco, CA 94080, USA. scappaticci.frank@gene.com
authors.forename: Frank A
authors.initials: FA
authors.lastname: Scappaticci
authors.forename: Louis
authors.initials: L
authors.lastname: Fehrenbacher
authors.forename: Thomas
authors.initials: T
authors.lastname: Cartwright
authors.forename: John D
authors.initials: JD
authors.lastname: Hainsworth
authors.forename: William
authors.initials: W
authors.lastname: Heim
authors.forename: Jordan
authors.initials: J
authors.lastname: Berlin
authors.forename: Fairooz
authors.initials: F
authors.lastname: Kabbinavar
authors.forename: William
authors.initials: W
authors.lastname: Novotny
authors.forename: Somnath
authors.initials: S
authors.lastname: Sarkar
authors.forename: Herbert
authors.initials: H
authors.lastname: Hurwitz
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000009:adverse effects*; D000911:Antibodies, Monoclonal / Q000009:adverse effects*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007410:Intestinal Diseases / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000139:chemically induced* / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D014945:Wound Healing / Q000187:drug effects*
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab