Skip to main content

Advertisement

Log in

Nasal septum perforation and bevacizumab

  • Original Paper
  • Published:
Medical Oncology Aims and scope Submit manuscript

Abstract

The use of targeted/biologic therapies is now commonplace in the treatment of malignant and non-malignant diseases. The novel mode of action of these drugs has resulted in unpredictable and in some cases unexpected side effects. Given the widespread use of bevacizumab and its distinct mode of action, it is important that oncologists report any unexpected adverse events that may be associated with the drug. Herein, we report three cases of spontaneous nasal septum perforation secondary to bevacizumab. We hypothesize an etiology for this rare event and reasons why it is reasonable to rechallenge the patient.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Torino F, Corsello SM, Longo R, et al. Hypothyroidism related to tyrosine kinase inhibitors: an emerging toxic effect of targeted therapy. Nat Rev Clin Oncol. 2009;6:219–28.

    Article  PubMed  CAS  Google Scholar 

  2. LoRusso P. Toward evidence-based management of the dermatologic effects of EGFR inhibitors. Oncology (Williston Park). 2009;23:186–94.

    Google Scholar 

  3. Folkman J. Tumor angiogenesis: therapeutic implications. N Engl J Med. 1971;285:1182–6.

    Article  PubMed  CAS  Google Scholar 

  4. Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9:669–76.

    Article  PubMed  CAS  Google Scholar 

  5. Hurwitz H, Fehrenbacher L, Novotny W, et al. Bevacizumab plus irinotecan, fluorouracil, and leucovorin for metastatic colorectal cancer. N Engl J Med. 2004;350:2335–42.

    Article  PubMed  CAS  Google Scholar 

  6. Sandler A, Gray R, Perry MC, et al. Paclitaxel-carboplatin alone or with bevacizumab for non-small-cell lung cancer. N Engl J Med. 2006;355:2542–50.

    Article  PubMed  CAS  Google Scholar 

  7. Gray R, Bhattacharya S, Bowden C, et al. Independent review of E2100: a phase III trial of bevacizumab plus paclitaxel versus paclitaxel in women with metastatic breast cancer. J Clin Oncol. 2009;27:4966–72.

    Article  PubMed  CAS  Google Scholar 

  8. Cohen MH, Shen YL, Keegan P, et al. FDA drug approval summary: bevacizumab (Avastin) as treatment of recurrent glioblastoma multiforme. Oncologist. 2009;14:1131–8.

    Article  PubMed  CAS  Google Scholar 

  9. Escudier B, Pluzanska A, Koralewski P, et al. Bevacizumab plus interferon alfa-2a for treatment of metastatic renal cell carcinoma: a randomised, double-blind phase III trial. Lancet. 2007;370:2103–11.

    Article  PubMed  Google Scholar 

  10. Cannistra SA, Matulonis UA, Penson RT, et al. Phase II study of bevacizumab in patients with platinum-resistant ovarian cancer or peritoneal serous cancer. J Clin Oncol. 2007;25:5180–6.

    Article  PubMed  CAS  Google Scholar 

  11. Van den Wyngaert T, Huizing MT, Fossion E, et al. Bisphosphonates in oncology: rising stars or fallen heroes. Oncologist. 2009;14:181–91.

    Article  PubMed  Google Scholar 

  12. Ross JS, Madigan D, Hill KP, et al. Pooled analysis of rofecoxib placebo-controlled clinical trial data: lessons for postmarket pharmaceutical safety surveillance. Arch Intern Med. 2009;169:1976–85.

    Article  PubMed  Google Scholar 

  13. Linda H, von Heijne A, Major EO, et al. Progressive multifocal leukoencephalopathy after natalizumab monotherapy. N Engl J Med. 2009;361:1081–7.

    Article  PubMed  CAS  Google Scholar 

  14. Chung CH, Mirakhur B, Chan E, et al. Cetuximab-induced anaphylaxis and IgE specific for galactose-alpha-1, 3-galactose. N Engl J Med. 2008;358:1109–17.

    Article  PubMed  CAS  Google Scholar 

  15. Genentech: http://www.gene.com/gene/products/information/oncology/avastin/ (2009). Accessed Nov 26th 2009.

  16. Hapani S, Chu D, Wu S. Risk of gastrointestinal perforation in patients with cancer treated with bevacizumab: a meta-analysis. Lancet Oncol. 2009;10:559–68.

    Article  PubMed  CAS  Google Scholar 

  17. Gressett SM, Shah SR. Intricacies of bevacizumab-induced toxicities and their management. Ann Pharmacother. 2009;43:490–501.

    Article  PubMed  CAS  Google Scholar 

  18. Lyman GH, Khorana AA. Cancer, clots and consensus: new understanding of an old problem. J Clin Oncol. 2009;27:4821–6.

    Article  PubMed  CAS  Google Scholar 

  19. Kozloff M, Yood MU, Berlin J, et al. Clinical outcomes associated with bevacizumab-containing treatment of metastatic colorectal cancer: the BRiTE observational cohort study. Oncologist. 2009;14:862–70.

    Article  PubMed  CAS  Google Scholar 

  20. van Heeckeren WJ, Ortiz J, Cooney MM, et al. Hypertension, proteinuria, and antagonism of vascular endothelial growth factor signaling: clinical toxicity, therapeutic target, or novel biomarker? J Clin Oncol. 2007;25:2993–5.

    Article  PubMed  Google Scholar 

  21. Glusker P, Recht L, Lane B. Reversible posterior leukoencephalopathy syndrome and bevacizumab. N Engl J Med. 2006;354:980–2. Discussion 980–2.

    Article  PubMed  CAS  Google Scholar 

  22. Bhattacharyya N. Clinical symptomatology and paranasal sinus involvement with nasal septal perforation. Laryngoscope. 2007;117:691–4.

    Article  PubMed  Google Scholar 

  23. Diamantopoulos, II, Jones NS. The investigation of nasal septal perforations and ulcers. J Laryngol Otol. 2001;115:541–4.

    PubMed  Google Scholar 

  24. Lee SL, Neskey D, Mouzakes J. Potential predisposition for nasal septal perforation with methotrexate use: report of 2 cases and literature review. Ear Nose Throat J. 2009;88:E12–4.

    PubMed  Google Scholar 

  25. Tan TH, Stevenson B, Yip D. Docetaxel-induced nasal septal perforation. Intern Med J. 2006;36:471–2.

    Article  PubMed  CAS  Google Scholar 

  26. Burkart CM, Grisel JJ, Hom DB. Spontaneous nasal septal perforation with antiangiogenic bevacizumab therapy. Laryngoscope. 2008;118:1539–41.

    Article  PubMed  CAS  Google Scholar 

  27. Marin AP, Sanchez AR, Arranz EE. Nasal septum perforation in a breast cancer patient treated with bevacizumab. Ann Oncol. 2009;20:1901–2.

    Article  PubMed  Google Scholar 

  28. Ruiz N, Fernandez-Martos C, Romero I, et al. Invasive fungal infection and nasal septum perforation with bevacizumab-based therapy in advanced colon cancer. J Clin Oncol. 2007;25:3376–7.

    Article  PubMed  Google Scholar 

  29. Traina TA, Norton L, Drucker K, et al. Nasal septum perforation in a bevacizumab-treated patient with metastatic breast cancer. Oncologist. 2006;11:1070–1.

    Article  PubMed  Google Scholar 

  30. Fakih MG, Lombardo JC. Bevacizumab-induced nasal septum perforation. Oncologist. 2006;11:85–6.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Nancy E. Kemeny.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Power, D.G., Kemeny, N.E. Nasal septum perforation and bevacizumab. Med Oncol 28, 89–93 (2011). https://doi.org/10.1007/s12032-010-9464-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12032-010-9464-9

Keywords

Navigation