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Bevacizumab in Colorectal Cancer: Toxicity - Epidemiology, Management and Correlation with Response

Yakir Rottenberg

During the recent years, the median survival of patients with metastatic colorectal cancer has improved dramatically. Gastroenterological interventions are frequently carried throughout the disease course, and familiarity with the various side effects of regimens which are commonly used in these patients is required. Bevacizumab, a humanized monoclonal antibody targeting VEGF, has a dominant role in the treatment of metastatic colon cancer. It has been shown in randomized trials to improve overall survival compared to standard treatment. Yet, this benefit is counterbalanced by a different safety profile compared to classic chemotherapy regimens, which is potentially serious and fatal. The side effects include impaired wound healing, bowel perforation, fistula formation, hemorrhage, thrombosis, proteinuria and hypertension. The current review focuses on the epidemiology, management and predictive value of bevacizumab’s toxicity.