All authors read and authorized the final version of the manuscript.. combination therapy is definitely well tolerated and its BAIAP2 toxicity is not considerably greater than that of the chemotherapy only. They shown significant improvement in survival for individuals with mCRC [1C3]. Initial data from community-based and observational studies show that the incidence and severity of adverse events with mixtures of bevacizumab and newer chemotherapy regimens are similar to those in the pivotal phase III trial with PI4KIIIbeta-IN-9 irinotecan, 5-fluorouracil, and leucovorin plus bevacizumab. Across trials, these side effects include a higher risk of grade 3 hypertension and grade 1 or 2 2 proteinuria, a slight increase in grade 3 or 4 4 bleeding, and impaired surgical wound healing in patients who undergo medical procedures during treatment with bevacizumab. [4]. Potentially life-threatening events (arterial thrombotic events, gastrointestinal perforation and fistula formation) have occurred in a small number of patients [5]. Methods All patients who received bevacizumab (BV) for mCRC during 4 years in the department of medical oncology at the Military Hospital MOHAMED V in Rabat (Morocco) were analyzed retrospectively. The bevacizumab was administrated with chemotherapy (FOLFOX or XELOX) at 7.5 mg/kg iv over 30-90 min in day 1 every 21 days. For each PI4KIIIbeta-IN-9 administration, was assessed the tolerability to bevacizumab perfusion based on patient clinical status, hypertension, proteinuria and other adverse events that were collected in our records. Results Fifty-one patients received bevacizumab for metastatic colorectal cancer during this period. The toxicities observed were minimal proteinuria in 19 cases (37.3%), haemorrhage in 14 cases (27.5%), hypertension in 12 cases (23.5%), venous thrombosis in 4 cases (7, 8%), arterial thrombosis in 2 cases (3.9%), and intestinal perforation in 2 cases (3.9%). However, dyslipidemia was found in 7 cases (13.7%) which represent a new side effect never described in the literature (Table 1). Table 1 Adverse effects observed in our study thead th align=”left” rowspan=”1″ colspan=”1″ Side effects /th th align=”center” rowspan=”1″ colspan=”1″ Percentage PI4KIIIbeta-IN-9 /th /thead Hypertension grade 1-223,5%Proteinuria grade 1-237,3%Venous thrombosis7,8%Arterial thrombosis3,9%Hemorrhage27,5%Gastro-intestinal perforation3,9% Dyslipidemia 13,7% Open in a separate window Discussion The safety profile of bevacizumab in combination with different chemotherapy has been evaluated in clinical trials of Phases II and III in mCRC and during two observational studies, each including about 2000 patients. Some side effects related to bevacizumab were unusual and specific; some of them can be explained by the mechanism of action of this agent: intestinal perforation, delayed wound healing that are related to poor blood supply or bleeding and thromboembolic events [4]. In general, a greater number of grade 3-4 adverse events was observed with bevacizumab + chemotherapy compared to chemotherapy alone. This increase was primarily related to the incidence of hypertension, the most common side effect and most unexpected nearly 40% of patients. The PI4KIIIbeta-IN-9 most serious adverse effect on the intestinal perforations that are infrequent (2% of patients), but can be fatal, and arterial thromboembolic events (Table 2). Table 2 Grade 3-4 adverse events observed during trials of bevacizumab in mCRC thead th align=”left” rowspan=”1″ colspan=”1″ Side effects /th th align=”center” rowspan=”1″ colspan=”1″ Bevacizumab + chemotherapy /th th align=”center” rowspan=”1″ colspan=”1″ chemotherapy /th /thead Hypertension grade 3-422 C 32%5 -8%Proteinuria grade 3- 423 C 32%11-22%Thromboembolic events18%16%Delayed healing of woods–Surgery under bevacizumab7-10%0%Bleeding, hemorrhage3- 5%2-3%Epistaxis20 C 40%0%Gastrointestinal perforation1 -2 %0% Open in a separate window Conclusion The use of bevacizumab requires a regular monitoring of blood pressure and quantification of the proteinuria especially in patients who are at greater risk of adverse events. However, monitoring the lipid profile in our patients may be necessary. What is known about this topic Bevacizumab is usually anti VEGF used in combination to chemotherapy in the first and second line in the treatment of metastatic colorectal cancer; phase III studies demonstrates the benefit of using bevacizumab in.
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