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Medline ® Abstract for Reference 91

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

91
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Gastrointestinal ulceration as a possible side effect of bevacizumab which may herald perforation.
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Tol J, Cats A, Mol L, Koopman M, Bos MM, van der Hoeven JJ, Antonini NF, van Krieken JH, Punt CJ
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Invest New Drugs. 2008 Aug;26(4):393-7. Epub 2008 Mar 12.
 
Chemotherapy plus bevacizumab is currently considered as the standard 1st line treatment of advanced colorectal cancer (ACC). Whereas GI perforation is a known side effect of bevacizumab, the development of GI ulcers has not been reported. We identified 18 patients with ACC who participated in a phase III multicentre trial which included chemotherapy and bevacizumab, who developed a GI ulcer (n = 6), perforation (n = 8) or both (n = 4). The risk of developing a symptomatic GI ulcer or perforation was 1.3% and 1.6%, respectively. Central review of the histology specimens showed ulceration and/or granulation tissue with neovascularisation. The majority (89%) of events developed early during treatment. Given these observations, as well as the relationship between VEGF and mucosal injury healing, we suggest that GI ulcers may occur as a side effect of treatment with bevacizumab and may herald perforation.
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Department of Medical Oncology, Radboud University Nijmegen Medical Centre, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
PMID