Implication of bevacizumab in fatal arterial thromboembolic incidents.

Bevacizumab, a humanized monoclonal antibody against vascular endothelial factor (VEGF), is approved for the treatment of metastatic colon cancer, but it has also shown efficacy in first line therapy of non-squamous-cell non-smallcell lung cancer, breast cancer and clear-cell renal cancer. Antiangiogenic therapy severe toxic effects such as stroke, myocardial infraction, angina, arterial thromboembolism, pulmonary embolism or haemorrhage, gastrointestinal perforation, heart failure should be taken into account during treatment with bevacizumab. We describe and discuss two cases of cancer patients who developed fatal arterial thromboembolic episodes after administration of bevacizumab. Due to the recent launch of antiangiogenic agents and the limited experience with their use in clinical practice, their adverse effects and pharmacological toxicities, sometimes fatal, are not well-established and a detailed registration of them is needed.

Multiple cutaneous ecchymoses associated with the administration of bevacizumab.

Nowadays, the introduction of combinational therapies with biological agents against advanced or resistant to chemotherapy tumors or for the treatment of cancer patients with organ failures becomes more and more attractive. The authors describe the case of a 60-year-old female patient with a multi-refractory to conventional cytotoxic therapy laryngeal cancer that was treated with cetuximab and bevacizumab combination therapy. Bevacizumab administration was associated with appearance of multiple cutaneous ecchymoses. This is a first-time reported adverse effect. Due to the recent launch of these agents and the limited experience of their use in clinical practice, their adverse effects and pharmacological toxicities are not well established and call for their detailed registration and reporting.