Charles Fuchs, MD: Bevacizumab Side-Effects

What side effects can be expected with bevacizumab, and which are most common and bothersome to patients? What serious side effects might occur with bevacizumab?

For the most part, bevacizumab is exceptionally well-tolerated. The notable toxicity that we already recognize is hypertension, namely modest elevation in blood pressure typically occurring over the course of weeks to months of administration. Nothing we see immediately after administration of the drug. Moreover, that's normally well-treated with any of the standard oral anti-hypertensive medications. I often use the ACE inhibitors in conjunction with patients who get hypertension, but ultimately the rates of patients who get hypertension are 10% of patients, 20% at most, but easily treated with standard remedies.

Beyond hypertension, there are some things to look out for. Proteinuria can occur early in patients who are on bevacizumab for months, so it is recommended you check urine for protein periodically, but the rates of proteinuria are pretty low. The only circumstance to which you would likely discontinue bevacizumab would be if there were 3+ proteinuria, and even then you could restart if the proteinuria diminishes again.

Unresectable Colon Cancer: Case 1

68-year-old man was diagnosed with advanced, unresectable colon cancer has just started treatment with FOLFIRI plus bevacizumab.