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Clin Drug Investig. 2019 Feb 8. doi: 10.1007/s40261-019-00757-w. [Epub ahead of print]

Bevacizumab Plus Direct Oral Anticoagulant Therapy in Ovarian Cancer Patients with Distal Deep Vein Thrombosis.

Author information

1
Department of Obstetrics and Gynecology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan. shinkomiyama@gmail.com.
2
Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan. shinkomiyama@gmail.com.
3
Department of Obstetrics and Gynecology, Toho University Faculty of Medicine, 6-11-1 Omorinishi, Ota-ku, Tokyo, 143-8541, Japan.
4
Department of Gynecology, Toho University Ohashi Medical Center, Tokyo, Japan.

Abstract

BACKGROUND AND OBJECTIVE:

Administration of bevacizumab to ovarian cancer patients with distal deep vein thrombosis (DVT) is problematic because of lack of evidence about the likely outcomes. We conducted a preliminary study in ovarian cancer patients with DVT who received bevacizumab combined with a direct oral anticoagulant (DOAC).

METHODS:

We retrospectively investigated patients with advanced or recurrent epithelial ovarian cancer and distal DVT diagnosed by ultrasonography who underwent chemotherapy containing bevacizumab (15 mg/kg every 3 weeks) combined with DOAC therapy.

RESULTS:

Bevacizumab was administered to 88 patients, including 7 patients (7.9%) receiving concomitant DOAC therapy for distal DVT. In these 7 patients, the median body mass index was 21.3 kg/m2, median D-dimer level at diagnosis of DVT was 4.3 µg/mL, and median duration of DOAC therapy was 8 months. Adverse events during DOAC therapy were grade 1 epistaxis and grade 1 hemorrhoidal bleeding in one patient each. DVT resolved in four patients and was unchanged in three patients, with no central progression or secondary thromboembolism.

CONCLUSION:

In ovarian cancer patients who have distal DVT, bevacizumab can possibly be administered safely when combined with a DOAC. To confirm this finding, further investigation on a larger scale will be required.

PMID:
30737671
DOI:
10.1007/s40261-019-00757-w

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