Intravitreal bevacizumab in the successful management of choroidal metastases secondary to lung and breast cancer unresponsive to systemic therapy: a case series.
OBJECTIVE
Management of choroidal metastases is commonly with systemic chemotherapy; however, if tumours are refractory to treatment and vision is endangered, local therapy modalities are feasible. A novel option is the use of intravitreal bevacizumab. This report presents three cases of choroidal metastatic tumours secondary to lung and breast cancer treated with intravitreal bevazizumab.


METHODS
Three patients with choroidal metastases secondary to lung and breast tumours were treated at the Ophthalmology Unit, University of Rome 'Sapienza', S.Andrea Hospital from January 2009 to August 2012. All patients developed vision loss with diagnosis of chorioidal metastasis during systemic chemotherapy. Off label intravitreal bevacizumab treatment was performed with two 1.25 mg injections in two patients and four injections in one patient at 30-day intervals.


RESULTS
Vision improved, subretinal fluid resolved, and choroidal tumour regression was obtained in all cases. Follow-up was 6, 9, and 12 months and there were no complications related to treatment.


CONCLUSIONS
Intravitreal bevacizumab administration represented an efficacious therapeutic option with rapid effect in the treatment of choroidal metastatic tumours unresponsive to systemic therapy. It can have a role in the management of these tumours by preventing vision loss and improving the quality of life of patients.
Ophthalmology Unit NESMOS Department, S.Andrea Hospital, Rome, Italy.
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V
Fenicia
DAI Testa/Collo, Azienda Policlinico Umberto I, University of Rome 'Sapienza', Rome, Italy.
S
S
Abdolrahimzadeh
Ophthalmology Unit NESMOS Department, S.Andrea Hospital, Rome, Italy.
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G
Mannino
Ophthalmology Unit NESMOS Department, S.Andrea Hospital, Rome, Italy.
S
S
Verrilli
Ophthalmology Unit NESMOS Department, S.Andrea Hospital, Rome, Italy.
M
M
Balestrieri
Ophthalmology Unit NESMOS Department, S.Andrea Hospital, Rome, Italy.
S M
SM
Recupero
D000231:Adenocarcinoma, Papillary / Q000188:drug therapy* / Q000556:secondary; D000328:Adult; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D000068258:Bevacizumab; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy* / Q000556:secondary; D002830:Choroid Neoplasms / Q000188:drug therapy* / Q000556:secondary; D005260:Female; D005451:Fluorescein Angiography; D006801:Humans; D058449:Intravitreal Injections; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology*; D008875:Middle Aged; D011788:Quality of Life; D058471:Subretinal Fluid / Q000187:drug effects; D041623:Tomography, Optical Coherence; D042461:Vascular Endothelial Growth Factor A / Q000037:antagonists & inhibitors; D014792:Visual Acuity / Q000187:drug effects
D020533:Angiogenesis Inhibitors; D061067:Antibodies, Monoclonal, Humanized; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000068258:Bevacizumab