Cancer Drug May Boost Risk of
Gastroinstestinal perforation
Review of trials finds Avastin with chemo doubles odds
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MONDAY, May 25, 2009 (HealthDay News) -- The use of the drug
bevacizumab (Avastin) in combination with chemotherapy greatly increases the
risk of gastrointestinal perforations in cancer patients, new research has
found.
These perforations are potentially life-threatening holes in the
wall of the stomach, small intestine or large bowel.
Bevacizumab is designed to slow the growth of tumors by cutting
off their blood supply. Concerns have been raised about bevacizumab and
gastrointestinal (GI) perforation, but so far no clinical trials have proved a
significant association, according to a news release.
In this new study, Dr. Sanjaykumar Hapani and colleagues at Stony
Brook University Cancer Center in New York analyzed findings from 17 trials
that included a total of 12,294 patients with a variety of solid tumors. The
overall incidence of GI perforation among the patients was 0.9 percent (the
death rate was 21.7 percent), but patients who took bevacizumab were twice as
likely to develop GI perforations.
The researchers also found that the risk of GI perforations among
patients taking bevacizumab was dose dependent. Compared to patients who didn't
take the drug, those who took 2.5 mg/kg per week of bevacizumab were 61 percent
more likely to develop GI perforations, while those who took 5 mg/kg per week
of the drug had a 167 percent higher risk.
The risk of GI perforation associated with bevacizumab also varied
according to tumor type, the study authors found. Patients with advanced
colorectal cancer and renal cell cancer had the highest risk, while those with
pancreatic cancer had the lowest risk.
"As bevacizumab is used extensively in routine cancer
treatment and in clinical trials, it will be increasingly important to
recognize symptoms indicating perforation and intervene promptly to reduce
morbidity and fatality," the researchers concluded. "Our study might
help to identify a subset of patients receiving bevacizumab at high risk of
bevacizumab-associated perforation."
The study appears online and in
the June print issue of The Lancet Oncology.
More information
SOURCE: The Lancet Oncology, news
release, May 24, 2009
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