Adverse Effects of Bevacizumab During Treatment for Metastatic Colorectal Cancer

Abstract

Objective: Bevacizumab has been increasingly used in combination chemotherapy for the treatment of metastatic or recurrent colorectal cancer. The aim of this report is to underline the possible risks associated with bevacizumab use. Methods: Between July 2005 and March 2013, a total of 130 patients with metastatic colorectal cancer who received oxaliplatin as first-line chemotherapy were divided into 2 groups those treated with bevacizumab (group A) and those without (group B), and compared. The primary endpoint was to clarify the profile of bevacizumab-induced adverse effects. Secondary endpoints examined therapeutic effects, including overall survival (OS). Results: The incidence of major side effects was almost equivalent, except for bleeding, between the 2 groups. With regard to the therapeutic effects, 1 patient in group A showed complete disappearance of multiple lung metastases without any evidence of recurrence. The median OS was 926 days (95% confidence interval [CI], 756-1257) in group A and 534 days (95% CI, 421-621) in group B (p < 0.01). Conclusion: The results demonstrate that bevacizumab prolonged survival in these patients although there was an increased risk of clinically significant bleeding.

Bevacizumab side effects and adverse clinical complications in colorectal cancer patients: review article

“…It was not statistically significant, but this case raised concern because no pulmonary effect was found when the study reinitiated chemotherapy irinotecan without bevacizumab. However, this study did not found any differences in tuberculosis cases for both bevacizumab and control groups 7 . A case–control study reported hand-foot syndrome in 58,6% cases, following co-treatment with bevacizumab and capecitabine, in which grade-3 level occurred in 5% of patients 21 .…”

“…In the hematological adverse event, the incidence of bleeding increased by adding bevacizumab to chemotherapy, but it was not statistically significant 7 , 8 , 11 , 12 , 20 , 21 . Some of the bleeding were clinically significant 7 , 8 but some were not 11 , 12 , 20 , 21 . Bleeding might be the effect of the anti-VEGF of bevacizumab, inhibiting coagulation and endothelial proliferation 7 .…”

“…Some of the bleeding were clinically significant 7 , 8 but some were not 11 , 12 , 20 , 21 . Bleeding might be the effect of the anti-VEGF of bevacizumab, inhibiting coagulation and endothelial proliferation 7 . Another most common adverse events reported in bevacizumab intervention was neutropenia 8 , 12 , 16 and the most frequent was grades 3–4 15 .…”