Intestinal perforation in colorectal cancers treated with bevacizumab (Avastin).
Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF), and it has shown promise as a clinical agent against metastatic colorectal cancer, and particularly in combination with chemotherapy. Bowel perforation is a known risk that's associated with bevacizumab use, but the etiology is unknown. Here we report on two cases of metastatic colorectal cancer in which the patients suffered from intestinal perforation after chemotherapy with bevacizumab. For the first case, a 47 year-old man had rectal cancer with concurrent liver and lung metastasis. He underwent chemotherapy with 5-fluorouracil, irinotecan and bevacizumab. Fever and abdominal pain developed seven days later, and rectal perforation was identified upon exploration 13 days later. For the second case, a 48 year-old woman had sigmoid colon cancer with peritoneal and ovary metastases. After seven days of chemotherapy with 5-fluorouracil, oxaliplatin and bevacizumab, exploratory surgery revealed a perforation at the ileum.
Choi
Young Il
YI
Department of Surgery, Kosin University College of Medicine, Busan, Korea.
Lee
Seung Hyun
SH
Ahn
Byung Kwon
BK
Baek
Sung Uhn
SU
Park
Seun Ja
SJ
Kim
Yang Soo
YS
Shin
Seong Hoon
SH
Gynecol Oncol. 2007 Apr;105(1):3-6
17383545
N Engl J Med. 2004 Jun 3;350(23):2335-42
15175435
Int J Radiat Oncol Biol Phys. 2006 Apr 1;64(5):1295-8
16503384
J Surg Oncol. 2005 Sep 1;91(3):173-80
16118771
Cancer Res. 1997 Oct 15;57(20):4593-9
9377574
J Clin Oncol. 2003 Jan 1;21(1):60-5
12506171
J Clin Oncol. 2006 Jul 20;24(21):3354-60
16849749
Oncology. 2005;69 Suppl 3:25-33
16301833
Curr Surg. 2006 Sep-Oct;63(5):334-7
16971205
Ann Surg Oncol. 2007 Jun;14(6):1860-9
17356952