title: [Bowel perforation associated with bevacizumab therapy in recurrent ovarian cancers without bowel obstruction or bowel involvement].
abstract: Recent reports showed that bevacizumab, a humanized recombinant antibody binding to vascular endothelial growth factor (VEGF), harbored a significant activity in advanced or recurrent epithelial ovarian cancers. However, life-threatening complications including arterial thrombosis, pulmonary hemorrhage, and gastrointestinal perforation (GIP) are not negligible. A Japanese case of bowel perforation associated with bevacizumab treatment in heavily pretreated ovarian cancers is reported. The case affected with refractory ovarian cancer had no signs of bowel obstruction and bowel thickness which are now recognized as risk factors of GIP associated with bevacizumab. After obtaining a written informed consent, a combination of weekly paclitaxel and weekly bevacizumab was administered as the fourth-line therapy. After nine cycles of the regimen, the case developed GIP, although the recurrent tumor showed a stable disease. After conservative therapy for two months, the patient died. The case was severely pretreated; however, there seemed to be no risk factors for GIP. Therefore, we do recommend that special cautions are required for the bevacizumab- based chemotherapy, especially severely pretreated ovarian cancer patients.
authors.affiliation: Dept. of Obstetrics and Gynecology, National Defense Medical College, Tokorozawa, Saitama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Takano
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Kikuchi
authors.forename: Masafumi
authors.initials: M
authors.lastname: Kato
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Yoshikawa
authors.forename: Tsunekazu
authors.initials: T
authors.lastname: Kita
mesh_terms: D000911:Antibodies, Monoclonal / Q000009:adverse effects* / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging; D007416:Intestinal Perforation / Q000139:chemically induced* / Q000000981:diagnostic imaging; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging / Q000188:drug therapy*; D010051:Ovarian Neoplasms / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000601:surgery; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab