Failure of treatment with anti-VEGF monoclonal antibody for long-standing POEMS syndrome.
We present the case of a 71-year-old woman with polyneuropathy, organomegaly, endocrinopathy, M-protein, and skin changes (POEMS) syndrome. Overproduction of vascular endothelial growth factor (VEGF), secreted by plasmacytoma, is considered responsible for the characteristic symptoms, and therefore anti-VEGF monoclonal antibody (bevacizumab) could be a therapeutic option. The patient was treated with bevacizumab 7 years after onset. Despite a dramatic decrease in serum VEGF levels, there was no clinical improvement, possibly because aberrant angiogenesis had already developed systemically. We suggest that careful consideration should be taken for indication of bevacizumab therapy, and this agent may be used in selected patients with a short duration POEMS syndrome.
Kanai
Kazuaki
K
Department of Neurology, Chiba University School of Medicine.
Kuwabara
Satoshi
S
Misawa
Sonoko
S
Hattori
Takamichi
T
D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D016878:POEMS Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D017211:Treatment Failure; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab