A Rupture of a Lung Metastatic Lesion of Colon Cancer, Leading to Pneumothorax Caused by Bevacizumab

Iida, Tomoya; Yabana, Takashi; Nakagaki, Suguru; Adachi, Takeya; Kondo, Yoshihiro

doi:10.2169/internalmedicine.55.7155

Cited by 11 publications

(16 citation statements)

References 13 publications

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“…In this case, air was observed inside part of the lung metastases; therefore, the second mechanism (formation of bronchopleural fistulas secondary to tumor necrosis) was considered to be involved in the onset of pneumothorax. Pneumothorax has also been reported in association with other molecular-targeted drugs, including sunitinib for renal cell cancer [ 8 ], pazopanib for soft tissue sarcoma [ 9 ], and bevacizumab for colon cancer or breast cancer [ 10 , 11 ]. These patients also had lung metastasis, and the mechanism of onset was similar to our case.…”

Section: Discussionmentioning

confidence: 99%

A Case of Pneumothorax after Treatment with Lenvatinib for Anaplastic Thyroid Cancer with Lung Metastasis

Yamazaki

Iwasaki

Yamashita

et al. 2018

Case Reports in Endocrinology

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A 63-year-old man was diagnosed with multiple lung metastases from anaplastic thyroid cancer and received lenvatinib. Follow-up computed tomography on day 34 of lenvatinib treatment showed pneumothorax. The pneumothorax was temporarily improved with chest drainage. However, pleurodesis was performed to treat a relapse of the pneumothorax. Pneumothorax during chemotherapy for a malignant tumor is considered a relatively rare complication. This case is the first documentation that pneumothorax may develop during lenvatinib treatment. The possible development of pneumothorax should be considered when lenvatinib is used in patients with lung metastasis.

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Section: Discussionmentioning

confidence: 99%

A Case of Pneumothorax after Treatment with Lenvatinib for Anaplastic Thyroid Cancer with Lung Metastasis

Yamazaki

Iwasaki

Yamashita

et al. 2018

Case Reports in Endocrinology

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“…Bevacizumab has a substantial number of side effects, including bleeding, high blood pressure, heart failure, proteinuria, thrombosis, and gastrointestinal (GI) perforation [6]. Pneumothorax has rarely been reported as a complication of bevacizumab [7][8][9][10][11][12][13]. The mechanism underlying the development of pneumothorax after bevacizumab therapy is not clear.…”

Section: Introductionmentioning

confidence: 99%

Pneumothorax as a Complication of Bevacizumab-Containing Chemotherapy: A Systematic Review of Case Reports

Rehman¹,

Ullah²,

Nagarajan³

et al. 2022

Cureus

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Bevacizumab is a monoclonal anti-vascular endothelial growth factor (VEGF) antibody that binds to and makes all of the VEGF isoforms inactive, and thus prevents angiogenesis, development, and the spread of the tumor. The most reported side effects after administering bevacizumab include bleeding, high blood pressure, heart failure, proteinuria, thrombosis, and gastrointestinal perforation. Pneumothorax has rarely been reported as a complication of bevacizumab, but with an unclear mechanism. This article aims to explore the occurrence of pneumothorax as a side effect after using bevacizumab through a systematic review of current case reports published on the topic. A literature search was conducted using PubMed, Google Scholar, ScienceDirect, and Directory of Open Access through the utilization of appropriate keywords, and case reports were selected based on predefined inclusion and exclusion criteria. Our results encompass five case reports that were further evaluated for demographic, clinical, and treatment parameters. This systematic review concludes that pneumothorax can occur after bevacizumab-containing chemotherapy although this side effect is relatively rare. Awareness regarding this possible side effect can assist clinicians during their practice in considering pneumothorax as a possible differential diagnosis when encountering patients presenting with pulmonary symptoms after starting bevacizumab-containing chemotherapy; hence, timely diagnosis and treatment can save a life.

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“…Furthermore, VEGF is known to be associated with recurrence and prognosis, and its inhibition is an important factor for treatment . Bevacizumab specifically binds to VEGF‐A and inhibits its binding to VEGF receptor (VEGFR)‐1 and VEGFR‐2, thereby inhibiting VEGF signal transduction . In colorectal cancer, many patients present with advanced disease or develop metastases within the first years after curative surgery, and bevacizumab has contributed to meaningful improvements in survival in patients with advanced colorectal cancer in recent years .…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab

Yoshimoto

Yoshikawa

Higashijima

et al. 2020

Annals of Gastroent Surgery

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Aim The purposes of this study are to present cases of emergency surgery in which gastrointestinal perforation occurred during bevacizumab administration, consider the indications for emergency surgery, and examine the safety of scheduled surgery after a washout period for bevacizumab. Methods (a) We retrospectively investigated seven patients who underwent emergency surgery for bevacizumab‐associated intestinal perforation. (b) We investigated 104 patients with advanced colorectal cancer treated with neoadjuvant therapy who underwent surgery from 2008 to 2018, retrospectively. Results (a) In the seven patients undergoing emergency surgery for gastrointestinal perforation, the median bevacizumab administration and washout periods were 16 weeks and 24 days, respectively. A stoma was created in all patients except in those who were not candidates. Two patients developed postoperative abdominal abscesses, and two patients died from perioperative sepsis and gastrointestinal bleeding, respectively; both of these patients had poor performance status. (b) In patients receiving bevacizumab (n = 45) and patients treated with bevacizumab‐free regimens as neoadjuvant therapy (n = 59), 31 and 52 patients received chemoradiotherapy, respectively. We found no correlation with postoperative complications with or without bevacizumab. Conclusion The surgical indications should be considered carefully in patients with gastrointestinal perforation secondary to bevacizumab administration. Meanwhile, after appropriate cessation time, scheduled surgery following bevacizumab administration is feasible.

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A Rupture of a Lung Metastatic Lesion of Colon Cancer, Leading to Pneumothorax Caused by Bevacizumab

Cited by 11 publications

References 13 publications

A Case of Pneumothorax after Treatment with Lenvatinib for Anaplastic Thyroid Cancer with Lung Metastasis

A Case of Pneumothorax after Treatment with Lenvatinib for Anaplastic Thyroid Cancer with Lung Metastasis

Pneumothorax as a Complication of Bevacizumab-Containing Chemotherapy: A Systematic Review of Case Reports

Bevacizumab‐associated intestinal perforation and perioperative complications in patients receiving bevacizumab

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