Bevacizumab is a humanized monoclonal antibody targeting vascular endothelial growth factor, and it has been shown to improve progression-free survival in patients with recurrent glioblastome multiforme when administered as second-line therapy. However, it has been associated with serious and fatal hemorrhagic events. Here, we present a 68-year-old male who developed severe periocular bleeding while on bevacizumab for recurrent temozolamide-resistant glioblastome multiforme.
StuppRMasonWPvan den BentMJ. European Organisation for Research and Treatment of Cancer Brain Tumor and Radiotherapy Groups; National Cancer Institute of Canada Clinical Trials Group. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med2005; 352: 987–996.
2.
TaalWOosterkampHMWalenkampAM. Single-agent bevacizumab or lomustine versus a combination of bevacizumab plus lomustine in patients with recurrent glioblastoma (BELOB trial): a randomised controlled phase 2 trial. Lancet Oncol2014; 15: 943–953.
3.
FriedmanHSPradosMDWenPY. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol2009; 27: 4733–4740.
4.
TakadaSHoshinoYItoH. Extensive bowel necrosis related to bevacizumab in metastatic rectal cancer patient: a case report and review of literature. Jpn J Clin Oncol2015; 45: 286–290.
5.
AhmadizarFOnland-MoretNCde BoerA. Efficacy and safety assessment of the addition of bevacizumab to adjuvant therapy agents in cancer patients: a systematic review and meta-analysis of randomized controlled trials. PLoS One2015; 10: e0136324–e0136324.
6.
ChangSMParneyIFHuangW. Glioma outcomes project investigators. patterns of care for adults with newly diagnosed malignant glioma. JAMA2005; 293: 557–564.
7.
ValtonenSTimonenUToivanenP. Interstitial chemotherapy with carmustine-loaded polymers for high-grade gliomas: a randomized double-blind study. Neurosurgery1997; 41: 44–48. discussion 48–49.
8.
WellerMvan den BentMHopkinsK. European Association for Neuro-Oncology (EANO) Task Force on Malignant Glioma. EANO guideline for the diagnosis and treatment of anaplastic gliomas and glioblastoma. Lancet Oncol2014; 15: e395–e403.
9.
Franceschi E, Bartolotti M and Brandes AA. Bevacizumab in recurrent glioblastoma: open issues. Future Oncol 2015; 11: 2655–2665.
10.
HangXFXuWSWangJX. Risk of high-grade bleeding in patients with cancer treated with bevacizumab: a meta-analysis of randomized controlled trials. Eur J Clin Pharmacol2011; 67: 613–623.
11.
HapaniSSherAChuD. Increased risk of serious hemorrhage with bevacizumab in cancer patients: a meta-analysis. Oncology2010; 79: 27–38.
12.
LaiATranANghiemphuPL. Phase II study of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol2011; 29: 142–148.
13.
ShermanJHAregawiDGLaiA. Optic neuropathy in patients with glioblastoma receiving bevacizumab. Neurology2009; 73: 1924–1926.
14.
Saran F, Chinot OL, Henriksson R, et al. Bevacizumab, temozolomide, and radiotherapy for newly diagnosed glioblastoma: comprehensive safety results during and after first-line therapy. Neuro Oncol 2016; 0: 1–11.
15.
FasihUShaikhNRahmanA. A one-year follow-up study of ocular and systemic complications of intravitreal injection of bevacizumab (Avastin). J Pak Med Assoc2013; 63: 707–710.
16.
DaySAcquahKMruthyunjayaP. Ocular complications after anti-vascular endothelial growth factor therapy in Medicare patients with age-related macular degeneration. Am J Ophthalmol2011; 152: 266–272.
