Intravitreal bevacizumab for consecutive multiple choroidal breast metastatic lesions

Mansour, Ahmad M.; Alameddine, Raafat

doi:10.1136/bcr.03.2012.6124

Cited by 16 publications

(15 citation statements)

References 11 publications

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“…[2][3][4][5][6][7][8][9] Our outcomes in two cases of adenocarcinoma of caecum, one breast carcinoma, and one adenocarcinoma of lung do not replicate this finding. Difference in pathologies do not explain this, as good effects have been described treating metastases from the same primaries: colon, 4 breast, 2,5,8 and lung. 6 One case, a breast metastasis, who had undergone EBRT in the previous 4 months with no immediate response, did regress after intravitreal bevacizumab.…”

Section: Discussioncontrasting

confidence: 37%

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Failure of intravitreal bevacizumab in the treatment of choroidal metastasis

Maudgil

Sears

Rundle

et al. 2015

Eye

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Background Metastasis to choroid is the most common intraocular malignancy, arising most frequently from carcinoma of breast in women and lung in men. Recent case reports have described successful use of intravitreal bevacizumab to achieve local control of such tumours. Materials and methods Five cases of choroidal metastases from varying primaries: breast, lung, and colon were treated with intravitreal bevacizumab, and tumour response observed and documented with serial photographs and B-scans. Results Four of the five tumours were seen to progress despite intravitreal bevacizumab treatment. Conclusions Intravitreal bevacizumab as the primary treatment of choroidal metastases is not recommended and should not delay more effective alternative treatments.

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Section: Discussioncontrasting

confidence: 37%

“…We used bevacizumab 1.25 mg in 0.05 ml, prepared from a vial commercially available for intravitreal use (Avastin). Previous reports have used bevacizumab 2.5 mg 3,5,6,9 and others 4 mg. 2,4 The most recent cohort published 7 used bevacizumab 1.25 mg and report regression in 3 cases with comparable pathologies.…”

Section: Discussionmentioning

confidence: 99%

Failure of intravitreal bevacizumab in the treatment of choroidal metastasis

Maudgil

Sears

Rundle

et al. 2015

Eye

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“…Choroidal metastases from lung cancer have been successfully treated with intravenous bevacizumab and chemotherapy 7 and intravitreal bevacizumab with concurrent chemotherapy. 8 There have only been four case reports in the literature where patients with lung 9 and breast [10][11][12] tumours, found to have new choroidal lesions despite systemic therapy, were successfully treated with intravitreal bevacizumab.…”

Section: Discussionmentioning

confidence: 99%

“…6 A few recent case reports have described the management of metastatic choroidal lesions through intravenous and/or intravitreal administration of bevacizumab with encouraging results. [7][8][9][10][11][12] We employed intravitreal bevacizumab in the management of three patients with primitive tumours of the lung and breast who developed choroidal metastases during chemotherapy. The study was approved by the Local Ethics Committee.…”

Section: Introductionmentioning

confidence: 99%

Intravitreal bevacizumab in the successful management of choroidal metastases secondary to lung and breast cancer unresponsive to systemic therapy: a case series

Fenicia

Abdolrahimzadeh

Mannino

et al. 2014

Eye

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Purpose 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. Patients and 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.

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“…[ 8 9 10 ] Intravitreal bevacizumab (Avastin, Genentech, Inc.) seems to be effective for early and small choroidal metastasis but does not work well in cases of larger choroidal tumor with exudative retinal detachment. [ 11 12 13 14 15 ]…”

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confidence: 99%

The effect of intravitreal bevacizumab and transpupillary thermotherapy on choroidal metastases and literature review

Lin

Tsai

2015

Indian J Ophthalmol

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Aims:To represent the effects of transpupillary thermotherapy (TTT) and intravitreal bevacizumab on choroidal metastases and review the literature.Settings and Design:A retrospective, interventional, noncomparative case series.Materials and Methods:A retrospective, interventional, noncomparative case series of five eyes in three patients with choroidal metastases was conducted. Fundus findings of choroidal metastases were divided into two types: Solitary or diffuse type. The size of the tumor was termed small (<10 mm diameter), medium (10–15 mm diameter) or large (>15 mm diameter). All eyes received one session of TTT followed by 3 weekly intravitreal bevacizumab injections as an adjuvant therapy. The parameters of treatment for TTT were 1.2–3 mm spot size, 150–300 mW, 60 s with the whole lesion covered confluently. The changes in preoperative and postoperative best-corrected visual acuity (BCVA) were recorded. Serial color fundus photography and optical coherent tomography were performed to measure the treatment efficacy.Results:All eight choroidal metastases were solitary type. The size of six tumors was small, the size of one tumor was medium, and the size of one tumor was large. All five eyes of the three patients had improvement of BCVA after treatment. Fundus photos revealed tumor shrinkage and the mean shrinkage percentage was 61.27 ± 21.71%. Optical coherence tomography revealed complete resolution of serous retinal detachment. There was no recurrence after 6 months follow-up.Conclusions:TTT combined with intravitreal bevacizumab injections brought about beneficial effects in reducing tumor size and improving vision in all five eyes of the three patients. Despite the retrospective nature of our study, the absence of control group and the size limitation that, of course, limit the statistical power, TTT combined with intravitreal bevacizumab seems to be efficient in providing another cost-reducing and time-saving treatment option for patients with choroidal metastases. The antineoplastic properties of bevacizumab make it a viable adjunctive therapy. Studies with more cases and a longer follow-up period are warranted.

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Intravitreal bevacizumab for consecutive multiple choroidal breast metastatic lesions

Cited by 16 publications

References 11 publications

Failure of intravitreal bevacizumab in the treatment of choroidal metastasis

Failure of intravitreal bevacizumab in the treatment of choroidal metastasis

Intravitreal bevacizumab in the successful management of choroidal metastases secondary to lung and breast cancer unresponsive to systemic therapy: a case series

The effect of intravitreal bevacizumab and transpupillary thermotherapy on choroidal metastases and literature review

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