Successful antiangiogenic combination therapy for pseudomyxoma peritonei with bevacizumab and capecitabine.
Effective systemic therapy for advanced pseudomyxoma peritonei (PMP) is the focus of investigation. We describe a case of PMP arising from an adenoma of the appendix in a 58-year-old man. First, the patient underwent explorative laparotomy with ileocoecal resection, but without possibility of major tumor debulking due to adhesive gross tumor masses. Subsequently, six cycles of Folfox IV chemotherapy were administered, without response, but with severe side effects. Upon progressive disease, a combination of bevacizumab and capecitabine led to a long term stabilization of disease and obvious improvement of performance status. Our case suggests that modulation of tumor microenvironment and angiogenesis by bevacizumab, potentially augmented by moochemotherapy, may be beneficial in borderline tumors such as PMP.
Sun
Wan-Ling
WL
Department of Internal Medicine/Oncology, Academic Natters Hospital, Natters, Austria.
Hutarew
Georg
G
Gradl
Johann
J
Gratzl
Melanie
M
Denz
Hubert
H
Fiegl
Michael
M
D018253:Adenoma, Villous / Q000150:complications / Q000188:drug therapy / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D001063:Appendiceal Neoplasms / Q000150:complications* / Q000601:surgery; D000068258:Bevacizumab; D000069287:Capecitabine; D003131:Combined Modality Therapy; D003841:Deoxycytidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D018450:Disease Progression; D005472:Fluorouracil / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D006552:Hernia, Inguinal / Q000150:complications / Q000601:surgery; D006801:Humans; D007080:Ileocecal Valve / Q000601:surgery; D002955:Leucovorin / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009944:Organoplatinum Compounds / Q000008:administration & dosage / Q000009:adverse effects; D010534:Peritoneal Neoplasms / Q000098:blood supply / Q000188:drug therapy / Q000209:etiology / Q000378:metabolism / Q000556:secondary* / Q000601:surgery; D011553:Pseudomyxoma Peritonei / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome
D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D009944:Organoplatinum Compounds; D003841:Deoxycytidine; D000068258:Bevacizumab; D000069287:Capecitabine; D002955:Leucovorin; D005472:Fluorouracil