Skip to main content

Advertisement

SpringerLink
Log in

Infusion of Bevacizumab increases the risk of intestinal perforation: results on a series of 143 patients consecutively treated

  • Original Article
  • Published:
Updates in Surgery Aims and scope Submit manuscript

Abstract

Bevacizumab is largely used in colorectal cancer patients. Postsurgical healing complications have been described for patients following treatment with Bevacizumab. We report three cases of spontaneous intestinal perforation following infusion of Bevacizumab. From January 2002 through October 2010, Bevacizumab was delivered in 143 patients. Spontaneous intestinal perforation occurred in 3 cases (2.1 %). Bevacizumab may result in severe complications. Therefore, it is important to consider every patient treated with Bevacizumab at risk for life-threatening gastro-intestinal complications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Carmelit P (2005) VEGF as a key mediator of angiogenesis in cancer. Oncology 69:4–10

    Article  Google Scholar 

  2. Thornton AD, Ravn P, Winslet M et al (2006) Angiogenesis inhibition with bevacizumab and the surgical management of colorectal cancer. Br J Surg 93:1456–1463

    Article  PubMed  CAS  Google Scholar 

  3. Verhoef C, de Wilt JH, Verheul HM (2006) Angiogenesis inhibitors: perspectives for medical, surgical and radiation oncology. Curr Pharm Des 12:2623–2630

    Article  PubMed  CAS  Google Scholar 

  4. Hurwitz H, Kabbinavar F (2005) Bevacizumab combined with standard fuoropyrimidine-based chemotherapy regimens to treat colorectal cancer. Oncology 69:17–24

    Article  PubMed  CAS  Google Scholar 

  5. Saif MW, Elfiky A, Salem RR (2007) Gastrointestinal perforation due to bevacizumab in colorectal cancer. Ann Surg Oncol 14:1860–1869

    Article  PubMed  Google Scholar 

  6. Kabbinavar F, Hurwitz HI, Fehrenbacher L et al (2003) Phase II, randomized trial comparing bevacizumab plus fluorouracil (FU)/leucovorin (LV) with FU/LV alone in patients with metastatic colorectal cancer. J Clin Oncol 21:60–65

    Article  PubMed  CAS  Google Scholar 

  7. Giantonio B, Catalano PJ, Meropol NJ et al (2007) Bevacizumab in combination with oxaliplatin, fluorouracil, and leucovorin (FOLFOX4) for previously treated metastatic colorectal cancer: results From the Eastern Cooperative Oncology Group Study E3200. J Clin Oncol 25:1539–1544

    Article  PubMed  CAS  Google Scholar 

  8. Gordon CR, Rojavin Y, Patel M, James EZ, Grana G, Kann B et al (2009) A review on bevacizumab wound healing. Ann Plast Surg 62:707–709

    Article  PubMed  CAS  Google Scholar 

  9. Van Cutsem E, Rivera F, Berry S, Kretzschmar A, Michael M, DiBartolomeo M, Mazier MA, Canon JL, Georgoulias V, Peeters M, Bridgewater J, Cunningham D, First BEAT Investigators (2009) Safety and efficacy of first-line bevacizumab with FOLFOX, XELOX, FOLFIRI and fluoropyrimidines in metastatic colorectal cancer: the BEAT study. Ann Oncol 20(11):1842–1847

    Article  PubMed  Google Scholar 

  10. Ferrara N, Hillan KJ, Gerber HP, Novotny W (2004) Discovery and development of bevacizumab, an anti-VEGF antibody for treating cancer. Nat Rev Drug Discov 3:391–400

    Article  PubMed  CAS  Google Scholar 

  11. Hurwitz H, Fehrenbacher L, Novotny W, Cartwright T, Hainsworth J, Heim W et al (2004) Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med 350(23):2335–2342

    Article  PubMed  CAS  Google Scholar 

  12. Sanjaykuma H, David C, Shenhong Wu (2009) Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol. 10(6):559–568

    Article  Google Scholar 

  13. Begè T, Lelong B, Iret F, Tuttini O, Guiramand J, Topart D et al (2009) Bevacizumab-related surgical site complication despite primary tumor resection in colorectal cancer patients. Ann Surg Oncol 16(4):856–860

    Article  PubMed  Google Scholar 

  14. Lordick F, Geinitz H, Theisen J, Sendler A, Sarba M (2006) Increased risk of ischemic bowel complications during treatment with bevacizumab after pelvic irradiation: report of three cases. Int. J. Radiat Oncol Biol. Phys. 64:1295–1298

    Article  PubMed  CAS  Google Scholar 

  15. August DA, Serrano D, Poplin E (2008) “Spontaneous”, delayed colon and rectal anastomotic complications associated with bevacizumab therapy. J Surg Oncol 87:180–185

    Article  Google Scholar 

Download references

Acknowledgments

The authors declare that they have no conflict of interest.

Conflict of interest

None.

Author information

Authors and Affiliations

  1. Department of General Surgery, Campus Bio-Medico University of Rome, Via Alvaro del Portillo, 200, Rome, Italy

    Domenico Borzomati, Gennaro Nappo, Sergio Valeri, Valter Ripetti & Roberto Coppola

  2. Department of Oncology, Campus Bio-Medico University of Rome, Rome, Italy

    Bruno Vincenzi

Authors
  1. Domenico Borzomati
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gennaro Nappo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sergio Valeri
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Bruno Vincenzi
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Valter Ripetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Roberto Coppola
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gennaro Nappo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Borzomati, D., Nappo, G., Valeri, S. et al. Infusion of Bevacizumab increases the risk of intestinal perforation: results on a series of 143 patients consecutively treated. Updates Surg 65, 121–124 (2013). https://doi.org/10.1007/s13304-013-0207-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13304-013-0207-2

Keywords

Search

Navigation