title: Ambiguous effects of anti-VEGF monoclonal antibody (bevacizumab) for POEMS syndrome.
abstract: OBJECTIVE
  Vascular endothelial growth factor (VEGF) plays an essential role in the pathophysiology of polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome. Anti-VEGF antibody (bevacizumab) appears to be an attractive therapeutic option. The aim of this study is to investigate the effects of bevacizumab for patients with POEMS syndrome.
  
  
  METHODS
  We reported six POEMS patients treated with bevacizumab and reviewed the literature.
  
  
  RESULTS
  The serum VEGF levels decreased immediately after bevacizumab administration in all six patients. However, four patients had entirely no clinical response, and two of them died. The remaining two showed improvement that could be explained by combined treatments. We also reviewed the literature and found 11 patients treated with bevacizumab; of these, only one was treated with bevacizumab alone. 10 had combined treatments, and four died without any response.
  
  
  CONCLUSIONS
  Both our experience and the literature suggest ambiguous effects of bevacizumab; inhibition of VEGF alone may be insufficient because multiple cytokines are upregulated, or aberrant neo-vascularization may have already fully developed in the advanced stage of POEMS syndrome.
authors: Department of Neurology, Graduate School of Medicine, Chiba University, , Chiba, Japan.
authors: Yukari
authors: Y
authors: Sekiguchi
authors: Sonoko
authors: S
authors: Misawa
authors: Kazumoto
authors: K
authors: Shibuya
authors: Saiko
authors: S
authors: Nasu
authors: Satsuki
authors: S
authors: Mitsuma
authors: Yuta
authors: Y
authors: Iwai
authors: Minako
authors: M
authors: Beppu
authors: Setsu
authors: S
authors: Sawai
authors: Shoichi
authors: S
authors: Ito
authors: Shigeki
authors: S
authors: Hirano
authors: Chiaki
authors: C
authors: Nakaseko
authors: Satoshi
authors: S
authors: Kuwabara
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000068258:Bevacizumab; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016878:POEMS Syndrome / Q000188:drug therapy*; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors* / Q000097:blood / Q000276:immunology
chemical_list: D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab
keywords: HAEMATOLOGY; NEUROPATHY