Bevacizumab toxicities and their management in ovarian cancer

Randall, Leslie M.; Monk, Bradley J.

doi:10.1016/j.ygyno.2010.02.021

Cited by 93 publications

(94 citation statements)

References 38 publications

(83 reference statements)

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“…This observation confirms that heavy pretreatment is an important factor involved in the occurrence of serious and fatal AEs, in clinical practice or in clinical trials (17,41).…”

Section: Discussionsupporting

confidence: 79%

“…This is likely due to the good performance status and relatively low incidence of pre-existing obstructive disease at the time of bevacizumab introduction in the current patients. Indeed, obstructive disease and peritoneal relapse have been reported to be the primary risk factors for GI perforation (45,46). Thus, the present results reveal that treating physicians are considering these known risk factors for bevacizumab toxicity before introducing the drug.…”

Section: Discussionmentioning

confidence: 53%

See 1 more Smart Citation

Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

Selle¹,

Emile²,

Pautier³

et al. 2016

Oncology Letters

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Abstract. The poor outcome of patients with recurrent ovarian cancer constitutes a continuous challenge for decision-making in clinical practice. In this setting, molecular targets have recently been identified, and novel compounds are now available. Bevacizumab has been introduced for the treatment of patients with ovarian cancer and is, to date, the most extensively investigated targeted therapy in this setting. However, potential toxicities are associated with the use of this monoclonal antibody. These toxicities have been reported in clinical trials, and can also be observed outside of trials. As limited data is currently available regarding the safety of bevacizumab treatment in daily clinical practice, the current retrospective study was designed to evaluate this. Data from 156 patients with recurrent ovarian cancer who had

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“…This observation confirms that heavy pretreatment is an important factor involved in the occurrence of serious and fatal AEs, in clinical practice or in clinical trials (17,41).…”

Section: Discussionsupporting

confidence: 79%

Section: Discussionmentioning

confidence: 53%

Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

Selle¹,

Emile²,

Pautier³

et al. 2016

Oncology Letters

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“…In fact, several FDA-approved TKIs that block VEGFRs, such as sunitinib, sorafenib, and pazopanib, are also commonly used antiangiogenic drugs in the clinic for treatment of human patients with RCC and other cancer types (37)(38)(39). Clinical experiences with bevacizumab and other anti-VEGF agents show that these drugs produce a range of adverse effects commonly seen in cancer patients, including hypertension, renal vascular injury often manifested by proteinuria and thrombotic microangiopathy, gastrointestinal perforation, and congestive heart failure (40)(41)(42). The anti-VEGF agent-induced broad adverse effects demonstrate that these drugs have a broad impact on vasculatures in multiple healthy tissues and organs.…”

Section: Discussionmentioning

confidence: 99%

Anti-VEGF– and anti-VEGF receptor–induced vascular alteration in mouse healthy tissues

Yang

Zhang

Cao

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

120

122

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Systemic therapy with anti-VEGF drugs such as bevacizumab is widely used for treatment of human patients with various solid tumors. However, systemic impacts of such drugs in host healthy vasculatures remain poorly understood. Here, we show that, in mice, systemic delivery of an anti-VEGF or an anti–VEGF receptor (VEGFR)-2 neutralizing antibody caused global vascular regression. Among all examined tissues, vasculatures in endocrine glands, intestinal villi, and uterus are the most affected in response to VEGF or VEGFR-2 blockades. Thyroid vascular fenestrations were virtually completely blocked by VEGF blockade, leading to marked accumulation of intraendothelial caveolae vesicles. VEGF blockade markedly increased thyroid endothelial cell apoptosis, and withdrawal of anti-VEGF resulted in full recovery of vascular density and architecture after 14 d. Prolonged anti-VEGF treatment resulted in a significant decrease of the circulating level of the predominant thyroid hormone free thyroxine, but not the minimal isoform of triiodothyronine, suggesting that chronic anti-VEGF treatment impairs thyroid functions. Conversely, VEGFR-1–specific blockade produced virtually no obvious phenotypes. These findings provide structural and functional bases of anti-VEGF–specific drug-induced side effects in relation to vascular changes in healthy tissues. Understanding anti-VEGF drug-induced vascular alterations in healthy tissues is crucial to minimize and even to avoid adverse effects produced by currently used anti-VEGF–specific drugs.

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“…Randomized studies have reported incidence of 4.4% in bevacizumab-treated patients and 1.9% in non-bevacizumab-treated patients [38]. In a meta-analysis of 1,745 patients [39], the reported incidence of ATEs was 3.8% in patients treated with bevacizumab and 1.7% in patients treated without bevacizumab, with an absolute number of 5.5…”

Section: Arterial Thromboembolic Eventsmentioning

confidence: 98%

Practical Management of Bevacizumab-Related Toxicities in Glioblastoma

et al. 2015

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Bevacizumab, currently an option for treatment of different types of tumors including glioblastoma, has a peculiar toxicity profile related to its antiangiogenic effect. Because some bevacizumab-related adverse events can be life threatening, it is important to identify risk factors and to establish treatment protocols to minimize treatment-related morbidity and mortality. In glioblastoma patients, the risk of developing certain side effects, such as gastrointestinal perforation, venous thromboembolism, and intracranial hemorrhages, is slightly higher than in patients treated with bevacizumab for other tumor types. We performed a systematic review of the side effects of bevacizumab and their incidence, causal mechanisms, and available treatments. Finally, we identified risk factors and proposed preventive and therapeutic measures for these adverse events. The Oncologist 2015;20:166-175Implications for Practice: Given the widespread use of bevacizumab in clinical practice, it is important to raise clinicians' awareness of the potential risks of this treatment. Our aim was to provide an overview of the most common side effects of bevacizumab and to suggest a practical approach for their management.

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Bevacizumab toxicities and their management in ovarian cancer

Cited by 93 publications

References 38 publications

Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

Safety of bevacizumab in clinical practice for recurrent ovarian cancer: A retrospective cohort study

Anti-VEGF– and anti-VEGF receptor–induced vascular alteration in mouse healthy tissues

Practical Management of Bevacizumab-Related Toxicities in Glioblastoma

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