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Medline ® Abstract for Reference 90

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

Case report of perforation of an ileal neobladder after treatment of rectal cancer with bevacizumab and comment on mechanisms of intestinal perforation associated with bevacizumab.
Liu SV, Gollard R, Iqbal S
J Clin Pharm Ther. 2012;37(5):607. Epub 2012 Mar 20.
WHAT IS KNOWN AND OBJECTIVE: Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor (VEGF) that has activity in several types of malignancies. One of the uncommon adverse effects is spontaneous bowel perforation. In patients who have undergone cystectomy, a loop of small bowel is often used to create a neobladder. We report the first case of ileal neobladder perforation associated with bevacizumab.
CASE SUMMARY: We describe a 38-year-old male with metastatic rectal cancer who was receiving treatment with bevacizumab when he presented with acute abdominal pain. Radiographic evaluation revealed perforation of his ileal neobladder.
WHAT IS NEW AND CONCLUSION: We describe the first report of ileal neobladder perforation in the setting of bevacizumab therapy. Although bowel perforation is a well-documented adverse effect of bevacizumab, this case suggests that displaced bowel tissue is still susceptible to these effects. We comment on what is known about bevacizumab-associated intestinal perforation.
Division of Medical Oncology, University of Southern California, Norris Comprehensive Cancer Center, Los Angeles, CA 90033, USA. stephen.liu@usc.edu