title: Osteonecrosis of the mandible associated with bevacizumab therapy.
abstract: Bevacizumab is a humanized antibody that blocks vascular endothelial growth factor and is of great value for the treatment of advanced cancer. Several adverse effects following its administration have been reported. To date, only 8 cases of osteonecrosis of the jaws associated with bevacizumab (without any association with bisphosphonates) have been reported. The aim of this article was to describe an original case of bevacizumab-related osteonecrosis of the jaw. A 61-year-old man diagnosed with advanced renal cell carcinoma was undergoing treatment with intravenous bevacizumab and temsirolimus when he spontaneously developed mandible osteonecrosis, which resolved after 3 months of conservative management. The present case reinforces recent speculation that the anti-angiogenic properties of bevacizumab may represent a potential new source of osteonecrosis of the jaws in patients undergoing cancer treatment. Multidisciplinary teams in cancer care should be aware of the possible association between osteonecrosis of the jaw and bevacizumab therapy.
authors.affiliation: Service of Dental Oncology, Instituto do Cancer do Estado de São Paulo (ICESP), Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo, Brazil. alanroger@fop.unicamp.br
authors.forename: Alan Roger
authors.initials: AR
authors.lastname: Santos-Silva
authors.forename: Giuliano Augusto
authors.initials: GA
authors.lastname: Belizário Rosa
authors.forename: Gilberto de
authors.initials: Gd
authors.lastname: Castro Júnior
authors.forename: Reinaldo Brito
authors.initials: RB
authors.lastname: Dias
authors.forename: Ana Carolina
authors.initials: AC
authors.lastname: Prado Ribeiro
authors.forename: Thaís Bianca
authors.initials: TB
authors.lastname: Brandão
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000009:adverse effects*; D000068258:Bevacizumab; D006801:Humans; D007571:Jaw Diseases / Q000139:chemically induced* / Q000473:pathology; D008297:Male; D008334:Mandible / Q000473:pathology*; D008875:Middle Aged; D010020:Osteonecrosis / Q000139:chemically induced* / Q000473:pathology; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab