Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

J. Tol; A. Cats; L. Mol; M. Koopman; M. M.E.M. Bos; J. J.M. Van Der Hoeven; N. F. Antonini; J. H.J.M. Van Krieken; C. J.A. Punt

doi:10.1007/s10637-008-9125-4

Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

J. Tol, A. Cats, L. Mol, M. Koopman, M. M.E.M. Bos, J. J.M. Van Der Hoeven, N. F. Antonini, J. H.J.M. Van Krieken, C. J.A. Punt

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Abstract

Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n=6), perforation (n=8) or both (n=4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.

Original language	English
Pages (from-to)	393-397
Number of pages	5
Journal	Investigational New Drugs
Volume	26
Issue number	4
DOIs	https://doi.org/10.1007/s10637-008-9125-4
Publication status	Published - 1 Aug 2008

Keywords

Bevacizumab
Colorectal cancer
Gastrointestinal ulcer
Perforation

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title = "Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation",

abstract = "Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n=6), perforation (n=8) or both (n=4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.",

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AU - Cats, A.

AU - Mol, L.

AU - Koopman, M.

AU - Bos, M. M.E.M.

AU - Van Der Hoeven, J. J.M.

AU - Antonini, N. F.

AU - Van Krieken, J. H.J.M.

AU - Punt, C. J.A.

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N2 - Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n=6), perforation (n=8) or both (n=4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.

AB - Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n=6), perforation (n=8) or both (n=4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.

KW - Bevacizumab

KW - Colorectal cancer

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Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation

Abstract

Keywords

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