Complete pathological response to bevacizumab and chemoradiation in advanced rectal cancer.
BACKGROUND
Localized rectal cancer responds well to 5-fluorouracil and radiation-based regimens. A phase I-II trial is currently testing the efficacy of adding bevacizumab, a VEGF-specific antibody, to standard chemoradiotherapy. The case presented here is a complete pathological response seen in a patient with extensive and locally invasive carcinoma after receiving this combined treatment.


METHODS
Physical examination, rectal ultrasound, PET-CT scan, laboratory tests, proctoscopic examination, chest radiograph, rectal forcep biopsies with immunohistochemistry, and protein and flow cytometric analyses.


METHODS
Large, invasive, ultrasound stage T4 carcinoma of the rectum, which was positive for survivin.


RESULTS
One 2-week cycle of bevacizumab alone, followed by 3 cycles of bevacizumab with continuous 5-fluorouracil infusion, and external-beam radiation therapy given 5 days per week to the pelvis, abdominoperineal resection with posterior vaginectomy, hysterectomy and bilateral salpingo-oophorectomy.
Willett
Christopher G
CG
Duke University Medical Center, Durham, NC 27710, USA. christopher.willett@duke.edu
Duda
Dan G
DG
di Tomaso
Emmanuelle
E
Boucher
Yves
Y
Czito
Brian G
BG
Vujaskovic
Zeljko
Z
Vlahovic
Gordana
G
Bendell
Johanna
J
Cohen
Kenneth S
KS
Hurwitz
Herbert I
HI
Bentley
Rex
R
Lauwers
Gregory Y
GY
Poleski
Martin
M
Wong
Terence Z
TZ
Paulson
Erik
E
Ludwig
Kirk A
KA
Jain
Rakesh K
RK
D000230:Adenocarcinoma / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003131:Combined Modality Therapy; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000473:pathology / Q000532:radiotherapy*; D012074:Remission Induction; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab