Incidence and management of bevacizumab-associated gastrointestinal perforations in patients with recurrent ovarian carcinoma Journal Article
| Authors: | Diaz, J. P.; Tew, W. P.; Zivanovic, O.; Konner, J.; Sabbatini, P. J.; dos Santos, L. A. ; Abu-Rustum, N. R.; Chi, D. S.; Aghajanian, C.; Barakat, R. R. |
| Article Title: | Incidence and management of bevacizumab-associated gastrointestinal perforations in patients with recurrent ovarian carcinoma |
| Abstract: | Objective: The objective of this study was to examine the incidence and management of bevacizumab-associated gastrointestinal (GI) perforations in patients with recurrent ovarian carcinoma. Methods: We identified all patients who received bevacizumab off protocol from August 2004-August 2008. We examined their medical records for reports of confirmed GI perforation, associated clinicopathological factors, treatment, and outcomes. Results: Six (4%) of 160 patients with ovarian carcinoma who had been treated with bevacizumab developed GI perforations, with a median of 4 (range, 2-8) previous cytotoxic regimens. The median serum CA-125 at the start of treatment was 228 U/mL (range, 50-3106 U/mL). The median number of bevacizumab cycles prior to perforation was 10.5 (range, 2-20). The median time from the last bevacizumab dose to diagnosis of GI perforation was 13 days (range, 1-28 days). Four (67%) patients underwent an exploratory surgery. At laparotomy, one had a gastric perforation and one had an appendiceal perforation; the site of perforation could not be identified in the other 2 Two patients (33%) were managed conservatively-one with a PEG tube and the other with supportive care. The median time of death from the date of diagnosis of GI perforation was 27 days (range, 4-326 days). Only two patients-one with a gastric and the other with an appendiceal perforation-survived > 65 days. The 30-day mortality rate following a bevacizumab-associated GI perforation was 50%. Conclusion: Bevacizumab-associated GI perforations in patients with recurrent ovarian carcinoma occurred in 4% of our patients. The prognosis of patients diagnosed with bevacizumab-associated GI perforations in this study was poor, and treatment should be individualized. © 2009 Elsevier Inc. All rights reserved. |
| Keywords: | adult; controlled study; treatment response; aged; aged, 80 and over; middle aged; survival rate; retrospective studies; young adult; major clinical study; case-control studies; mortality; bevacizumab; doxorubicin; paclitaxel; cancer patient; recurrent cancer; laparotomy; ovarian cancer; ovarian neoplasms; carboplatin; neoplasm recurrence, local; incidence; recurrence; cyclophosphamide; drug effect; medical record review; ovary; survival time; antibodies, monoclonal; ovary carcinoma; ca 125 antigen; time of death; appendix perforation; avastin; gastrointestinal perforations; stomach perforation; intestinal perforation |
| Journal Title: | Gynecologic Oncology |
| Volume: | 116 |
| Issue: | 3 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2010-03-01 |
| Start Page: | 335 |
| End Page: | 339 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2009.11.017 |
| PUBMED: | 20004956 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | --- - "Cited By (since 1996): 3" - "Export Date: 20 April 2011" - "CODEN: GYNOA" - "Source: Scopus" |
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629Barakat -
707Chi -
155Konner -
48Diaz -
888Abu-Rustum -
262Sabbatini -
291Zivanovic -
607Aghajanian -
244Tew
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