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Nasal septum perforation: a side effect of bevacizumab chemotherapy in breast cancer patients.

Mailliez A, Baldini C, Van JT, Servent V, Mallet Y, Bonneterre J - Br. J. Cancer (2010)

Bottom Line: Side effects were graded according to CTCAE.Bevacizumab was associated with docetaxel (100 mg m(-2) every 3 weeks) in two pts and with weekly paclitaxel in one.Several mechanisms could be involved (mucositis, delayed tissue repair, antiangiogenic action of taxanes).

View Article: PubMed Central - PubMed

Affiliation: Breast Cancer Department, Centre Oscar Lambret, 3 rue F Combemale, Lille 59000, France. a-mailliez@o-lambret.fr

ABSTRACT

Background: Bevacizumab is an anti-vascular endothelial growth factor approved in association with paclitaxel or docetaxel as first line in patients (pts) with metastatic breast cancer. Rare cases of nasal septum perforations have been reported. We report our experience of nasal perforation in breast cancer pts receiving bevacizumab and chemotherapy either in the adjuvant or in the metastatic settings.

Methods: Between 1 January and 31 December 2009, 70 pts received bevacizumab together with chemotherapy. All the pts who had received bevacizumab were referred to the ENT specialist. Symptoms potentially related were looked for. Side effects were graded according to CTCAE.

Results: Five nasal septum perforations were diagnosed (5 out of 70; 7.14%). Bevacizumab dose was 15 mg kg(-1) 3 weekly. Three pts were metastatic. Bevacizumab was associated with docetaxel (100 mg m(-2) every 3 weeks) in two pts and with weekly paclitaxel in one. The last two pts received bevacizumab in combination with anthracyclin and then taxanes in the adjuvant setting. In these two cases, nasal septum perforation occurred at the time of docetaxel treatment.

Conclusion: A high incidence of nasal septum perforation has been shown in pts with breast cancer receiving bevacizumab together with chemotherapy. Several mechanisms could be involved (mucositis, delayed tissue repair, antiangiogenic action of taxanes).

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Related in: MedlinePlus

Nasal septum perforation.
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fig1: Nasal septum perforation.

Mentions: Five nasal septum perforations were found in the 70 pts (7.14% Figure 1). At diagnosis, Bevacizumab was part of the treatment of the five pts. Bevacizumab dose was 15 mg kg−1 3 weekly in all the pts. The median time between beginning of Bevacizumab treatment and diagnosis of nasal septum perforation was 21 weeks (range, 9–45 weeks). The median age of affected pts was 42 years (range, 33–50 years). Three pts were metastatic and had received previous chemotherapy in the adjuvant setting (anthracyclin based for one and sequential anthracyclin then docetaxel for the others). One of them had epistaxis and two of them developed mucosal toxicities (grade1 or 2) in the adjuvant setting. Bevacizumab was associated with docetaxel (100 mg m−2 every 3 weeks) in two pts and with weekly paclitaxel for one pt.


Nasal septum perforation: a side effect of bevacizumab chemotherapy in breast cancer patients.

Mailliez A, Baldini C, Van JT, Servent V, Mallet Y, Bonneterre J - Br. J. Cancer (2010)

Nasal septum perforation.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2966623&req=5

fig1: Nasal septum perforation.
Mentions: Five nasal septum perforations were found in the 70 pts (7.14% Figure 1). At diagnosis, Bevacizumab was part of the treatment of the five pts. Bevacizumab dose was 15 mg kg−1 3 weekly in all the pts. The median time between beginning of Bevacizumab treatment and diagnosis of nasal septum perforation was 21 weeks (range, 9–45 weeks). The median age of affected pts was 42 years (range, 33–50 years). Three pts were metastatic and had received previous chemotherapy in the adjuvant setting (anthracyclin based for one and sequential anthracyclin then docetaxel for the others). One of them had epistaxis and two of them developed mucosal toxicities (grade1 or 2) in the adjuvant setting. Bevacizumab was associated with docetaxel (100 mg m−2 every 3 weeks) in two pts and with weekly paclitaxel for one pt.

Bottom Line: Side effects were graded according to CTCAE.Bevacizumab was associated with docetaxel (100 mg m(-2) every 3 weeks) in two pts and with weekly paclitaxel in one.Several mechanisms could be involved (mucositis, delayed tissue repair, antiangiogenic action of taxanes).

View Article: PubMed Central - PubMed

Affiliation: Breast Cancer Department, Centre Oscar Lambret, 3 rue F Combemale, Lille 59000, France. a-mailliez@o-lambret.fr

ABSTRACT

Background: Bevacizumab is an anti-vascular endothelial growth factor approved in association with paclitaxel or docetaxel as first line in patients (pts) with metastatic breast cancer. Rare cases of nasal septum perforations have been reported. We report our experience of nasal perforation in breast cancer pts receiving bevacizumab and chemotherapy either in the adjuvant or in the metastatic settings.

Methods: Between 1 January and 31 December 2009, 70 pts received bevacizumab together with chemotherapy. All the pts who had received bevacizumab were referred to the ENT specialist. Symptoms potentially related were looked for. Side effects were graded according to CTCAE.

Results: Five nasal septum perforations were diagnosed (5 out of 70; 7.14%). Bevacizumab dose was 15 mg kg(-1) 3 weekly. Three pts were metastatic. Bevacizumab was associated with docetaxel (100 mg m(-2) every 3 weeks) in two pts and with weekly paclitaxel in one. The last two pts received bevacizumab in combination with anthracyclin and then taxanes in the adjuvant setting. In these two cases, nasal septum perforation occurred at the time of docetaxel treatment.

Conclusion: A high incidence of nasal septum perforation has been shown in pts with breast cancer receiving bevacizumab together with chemotherapy. Several mechanisms could be involved (mucositis, delayed tissue repair, antiangiogenic action of taxanes).

Show MeSH
Related in: MedlinePlus