Targeted Oncology

, Volume 6, Issue 4, pp 253–258 | Cite as

Posterior reversible encephalopathy syndrome induced by anti-VEGF agents

  • Camille Tlemsani
  • Olivier Mir
  • Pascaline Boudou-Rouquette
  • Olivier Huillard
  • Karin Maley
  • Stanislas Ropert
  • Romain Coriat
  • François Goldwasser
Day-to-Day Practice


Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity that may occur in patients receiving anti-vascular endothelial growth factor (VEGF) agents such as bevacizumab and tyrosine kinase inhibitors. Little is known about the characteristics of patients at risk for PRES under anti-VEGF agents. We carried out a comprehensive review of reports documenting the occurrence of PRES in patients receiving anti-VEGF agents. Twenty-six patients are described with a majority of females (73.1%). Almost a third of patients had a past history of hypertension. The most common symptoms included headache, visual disturbance and seizure. A vast majority of patients had hypertension at the diagnosis of PRES, and proteinuria was detectable each time it was investigated. Neurological outcome was favorable in all cases with a symptomatic treatment including blood pressure control. The risk of PRES is increased when blood pressure is poorly controlled and when proteinuria is detectable. The clinical course appears favorable with a symptomatic treatment. PRES is a potentially severe but manageable toxicity of anti-VEGF agents.


Reversible posterior leukoencephalopathy syndrome Angiogenesis inhibitors VEGF-A Cancer Outcomes 


Conflicts of interest statement

Dr. Mir has acted as paid consultant for Roche. Prof. Goldwasser has acted as paid consultant for Pfizer and Bayer. The other authors have no conflict of interest to declare.


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Copyright information

© Springer-Verlag 2011

Authors and Affiliations

  • Camille Tlemsani
    • 1
  • Olivier Mir
    • 1
  • Pascaline Boudou-Rouquette
    • 1
  • Olivier Huillard
    • 1
  • Karin Maley
    • 1
  • Stanislas Ropert
    • 1
  • Romain Coriat
    • 1
  • François Goldwasser
    • 1
  1. 1.CERIA (Centre for Research on Angiogenesis Inhibitors), Department of Medical Oncology, Cochin Teaching Hospital, AP-HPUniversité Paris DescartesParisFrance

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