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Invest New Drugs. 2009 Apr;27(2):184-7. doi: 10.1007/s10637-008-9162-z. Epub 2008 Jul 30.

Bowel perforation in non-small cell lung cancer after bevacizumab therapy.

Author information

  • 1Chirurgische Klinik I, Charité Campus Benjamin Franklin, Hindenburgdamm 30, 12200, Berlin, Germany. elisabeth.schellhaas@charite.de

Abstract

BACKGROUND:

Bevacizumab is increasingly used in combination with chemotherapy for treatment of unresectable non-small cell lung cancer. The aim of this report is to underline possible risks associated with this otherwise well-tolerated drug.

PATIENT:

A 69-year-old patient with metastatic non-small cell lung cancer was started on a palliative chemotherapy regimen containing carboplatin, paclitaxel, and bevacizumab.

RESULTS:

After the second cycle of chemotherapy, the patient developed abdominal pain. On emergency laparotomy, there was diffuse perforation of the colonic wall, so the patient underwent a Hartmann's procedure with subtotal colectomy. Histopathological examination confirmed the diagnosis of ischemic colitis.

CONCLUSION:

Gastrointestinal perforation is a known adverse event of bevacizumab therapy which so far has occurred only in patients with predisposing risk factors. Our patient illustrates that there must always remain a high index of suspicion regarding bowel perforation in patients developing acute abdominal pain under bevacizumab therapy, even if they have no apparent risk factors.

PMID:
18665327
[PubMed - indexed for MEDLINE]
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