[A case of severe bevacizumab-induced ischemic pancolitis, treated with conservative management]

Korean J Gastroenterol. 2011 Jul;58(1):42-6. doi: 10.4166/kjg.2011.58.1.42.
[Article in Korean]

Abstract

Bevacizumab (Avastin(Ⓡ)) is a monoclonal antibody against the vascular endothelial growth factor (VEGF) receptor that increases the overall survival rate when added to standard chemotherapy regimens in patients with metastatic colorectal cancer. The known toxicities of bevacizumab are hypertension, proteinuria, wound healing complications, arterial thrombosis, bleeding, and gastrointestinal complications. Especially ischemic colitis can rapidly develop into bowel perforation, so an emergency operation often is needed. Recently, a 65-year-old male patient developed ischemic pancolitis after FOLFOX (85 mg/m(2) Oxaliplatin, d1; 200 mg/m(2) Leucovorin, d1; 400 mg/m(2) 5-FU iv bolus, d1-2; and 600 mg/m(2) 5-FU, d1-2, every two wk) and Bevacizumab combination chemotherapy was administered. However, he recovered after early conservative care without surgery. We report this case with a review of literature.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab
  • Colitis, Ischemic / chemically induced*
  • Colitis, Ischemic / diagnostic imaging
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / pathology
  • Drug Administration Schedule
  • Fluorouracil / administration & dosage
  • Humans
  • Intubation, Gastrointestinal
  • Leucovorin / administration & dosage
  • Male
  • Organoplatinum Compounds / administration & dosage
  • Oxaliplatin
  • Tomography, X-Ray Computed

Substances

  • Antibodies, Monoclonal, Humanized
  • Organoplatinum Compounds
  • Oxaliplatin
  • Bevacizumab
  • Leucovorin
  • Fluorouracil