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Medline ® Abstract for Reference 189

of 'Toxicity of molecularly targeted antiangiogenic agents: Non-cardiovascular effects'

Bevacizumab-induced nasal septal perforation: incidence of symptomatic, confirmed event(s) in colorectal cancer patients.
Ramiscal JA, Jatoi A
Acta Oncol. 2011;50(4):578. Epub 2010 Nov 26.
PURPOSE: In breast cancer patients, Mailliez and others described that 5 of 70 patients (7%) developed a bevacizumab-induced nasal septal perforation. However, to date, no studies have reported such rates in colorectal cancer patients, who derive a survival advantage with this drug.
METHODS: This study examined the incidence of bevacizumab-induced, clinically symptomatic, otolaryngology specialist-confirmed nasal septal perforation among 100 patients who had been consecutively-treated for metastatic colorectal cancer.
RESULTS: The incidence of nasal septal perforation was 1% (95% confidence intervals: -0.95% to 2.95%). This single adverse event was successfully managed conservatively. Within the whole group, 94 had been treated with bevacizumab at 5 mg/kg every two weeks, except for four patients treated at higher doses. The median number of bevacizumab doses (range) was seven (1-96). Concomitant chemotherapy had been prescribed to all patients, consisting of oxaliplatin, 5-fluorouracil, leucovorin, as per one of the FOLFOX regimens (44 patients); irinotecan, 5-fluorouracil, leucovorin, as per the FOLFIRI regimen (13 patients); both these regimens andno other (five patients); or a different regimen (38 patients).
CONCLUSION: Nasal septal perforation from bevacizumab occurs infrequently among colorectal cancer patients.
Mayo Clinic Medical School, Rochester, Minnesota 55905, USA.