Bevacizumab-Induced Reversible Thrombocytopenia in a Patient with Adenocarcinoma of Colon: Rare Adverse Effect of Bevacizumab

Kumar, Jeevan; Bhargava, Manorama; Aggarwal, Shyam

doi:10.1155/2012/695430

Cited by 11 publications

(7 citation statements)

References 11 publications

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“…counts were reduced at time of the event and prior bevacizumab was associated with reduction in platelet counts, an adverse event previously reported [9]. Both of these findings imply a possible secondary immune thrombocytopenia (ITP) [10].…”

Section: Discussionsupporting

confidence: 51%

Case Series of Cancer Patients Treated With Galunisertib, a Transforming Growth Factor-Beta Receptor I Kinase Inhibitor in a First-in-Human Dose Study

et al. 2014

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Galunisertib (LY2157299 monohydrate) is a first-in-class small molecule inhibitor (SMI) of the transforming growth factor-beta (TGF-β) signaling pathway. Some adverse events were associated with galunisertib during the first-in-human dose (FHD) study. Among these adverse events (n = 11) were four cases of infection, two cases of thromboembolic events and two cases of thrombocytopenia. In one of the patients with thromboembolic events, an autopsy was also performed to examine possible changes of the aorta. No significant histopathologic changes were observed. Single cases of grade 2 diarrhea (only associated with drug intake), stroke (after resection for relapsed glioma), and pre-existing co-primary tumor (possible colorectal cancer) were observed. Because TGF-β plays an important role in tissue homeostasis and in immune response regulation, the present case series may serve as a future reference for adverse events observed in subsequent clinical trials with galunisertib.

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Section: Discussionsupporting

confidence: 51%

Case Series of Cancer Patients Treated With Galunisertib, a Transforming Growth Factor-Beta Receptor I Kinase Inhibitor in a First-in-Human Dose Study

et al. 2014

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“…A phase III randomized trial (bevacizumab in glioblastoma) showed a higher incidence of thrombocytopenia versus placebo (34.1% vs. 27.3%) (31). In a previous case report, a 59-yearold man with adenocarcinoma of the colon developed thrombocytopenia after bevacizumab treatment (32). The meta-analysis by Kut et al indicated that VEGF is mostly concentrated in the platelets in cancer patients (33), while in vitro experiments have suggested that VEGF exerts potentiating effects on platelet activation (34).…”

Section: Discussionmentioning

confidence: 97%

Immune-related adverse event profile of combination treatment of PD-(L)1 checkpoint inhibitors and bevacizumab in non-small cell lung cancer patients: data from the FDA adverse event reporting system

Bai¹,

Tian²,

Pacheco³

et al. 2021

Transl Lung Cancer Res

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Background: Immune checkpoint inhibitors (ICIs) and bevacizumab-based therapy are a promising treatment approach to significantly improving overall survival (OS) of non-small cell lung cancer (NSCLC) patients. However, the incidence of adverse events induced by a combination treatment with programmed cell death-1 or programmed death ligand 1 [PD-(L)1] inhibitor and bevacizumab remains unknown. The current evidence from prospective studies is limited. Thus, efforts using real-world data to further improve our understanding of the potential adverse events will be necessary.Methods: The present study included 15,872 participants with NSCLC in the FDA Adverse Event Reporting System (FAERS) database from April 2013 to September 2019. The definition of adverse events (AEs) relied on the Medical Dictionary for Regulatory Activities (MedDRA). Statistical analysis was performed, and odds ratio (ORs) with 95% confidence intervals (CIs) were calculated.Results: Of the 15,872 participants with NSCLC, 15,463 cases were treated with the PD-(L)1 inhibitor monotherapy, while 409 cases were treated with both PD-(L)1 inhibitor and bevacizumab. Compared with monotherapy, combination therapy had lower risks of pneumonitis, respiratory failure, edema, disease progression, and death; however, combination therapy was also associated with significantly higher risks of pyrexia, general physical health deterioration, stomatitis, dehydration, thrombocytopenia, peripheral neuropathy, nephritis, bone marrow failure, immune thrombocytopenic purpura, neutropenia, and serious AEs. The results of the multivariate analysis suggested that combination therapy was the independent risk factor for pyrexia, neutropenia, nephritis, ITP, and the independent protective factor for respiratory failure. Conclusions:We observed that the spectrum and risk of irAEs differed widely between therapeutic regimens, and irAEs involved multiple organ systems both in monotherapy or combination therapy.Deepening our understanding of irAEs has a great clinical value for improving individualized clinical patient management and the safety of medication use.

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“…had no bleeding with mild thrombocytopenia ( 18 ). In the other case reported by Kumar et al., the patient developed severe thrombocytopenia with melena and epistaxis, attributable to bevacizumab ( 19 ). Our patient had no bleeding, and platelet count was slightly decreased.…”

Section: Discussionmentioning

confidence: 90%

Bevacizumab-induced immune thrombocytopenia in an ovarian cancer patient with mixed connective tissue disease: case report and literature review

Zhang,

Yang,

Wang

et al. 2024

Front. Immunol.

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Drug-induced immune thrombocytopenia is an adverse reaction marked by accelerated destruction of blood platelets. In cancer therapy, thrombocytopenia has many other causes including bone marrow suppression induced by chemotherapeutic agents, infection, and progression of cancer; drug-induced thrombocytopenia can easily be misdiagnosed or overlooked. Here, we present a case of an ovarian cancer patient with a history of mixed connective tissue disease who underwent surgery followed by treatment with paclitaxel, cisplatin, and bevacizumab. The patient developed acute isolated thrombocytopenia after the sixth cycle. Serum antiplatelet antibody testing revealed antibodies against glycoprotein IIb. After we analyzed the whole therapeutic process of this patient, drug-induced immune thrombocytopenia was assumed, and bevacizumab was conjectured as the most probable drug. Thrombocytopenia was ultimately successfully managed using recombinant human thrombopoietin, prednisone, and recombinant human interleukin-11. We provide a summary of existing literature on immune thrombocytopenia induced by bevacizumab and discuss related mechanisms and triggers for drug-induced immune thrombocytopenia. The present case underscores the potential of bevacizumab to induce immune-mediated thrombocytopenia, emphasizing the need for heightened vigilance towards autoimmune diseases or an autoimmune-activated state as plausible triggers for rare drug-induced immune thrombocytopenia in cancer therapy.

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Bevacizumab-Induced Reversible Thrombocytopenia in a Patient with Adenocarcinoma of Colon: Rare Adverse Effect of Bevacizumab

Cited by 11 publications

References 11 publications

Case Series of Cancer Patients Treated With Galunisertib, a Transforming Growth Factor-Beta Receptor I Kinase Inhibitor in a First-in-Human Dose Study

Case Series of Cancer Patients Treated With Galunisertib, a Transforming Growth Factor-Beta Receptor I Kinase Inhibitor in a First-in-Human Dose Study

Immune-related adverse event profile of combination treatment of PD-(L)1 checkpoint inhibitors and bevacizumab in non-small cell lung cancer patients: data from the FDA adverse event reporting system

Bevacizumab-induced immune thrombocytopenia in an ovarian cancer patient with mixed connective tissue disease: case report and literature review

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