Current Oncology Reports

, Volume 14, Issue 4, pp 277–284

Incidence and Management of Gastrointestinal Perforation from Bevacizumab in Advanced Cancers

  • Taher Abu-Hejleh
  • James J. Mezhir
  • Michael J. Goodheart
  • Thorvardur R. Halfdanarson
Palliative Medicine (A Jatoi, Section Editor)


Bevacizumab (Avastin™, Genentech) is a monoclonal antibody that deactivates the vascular endothelial growth factor leading to disruption of vital cancer signaling pathways and inhibition of angiogenesis which results in its anti-tumor activity. The use of bevacizumab in treating cancers has steadily increased since it was initially approved by the Food and Drug Administration for metastatic colorectal cancer. Clinical trials have revealed that bevacizumab has serious side effects, including spontaneous bowel perforation, which can occur in patients who have no involvement of the gastrointestinal tract by cancer. Although risk factors for bevacizumab-associated bowel perforation have been identified, it is still unclear which patients are specifically at risk for this complication. The management of bevacizumab-induced bowel perforation depends on the clinical presentation and the goals of care set by the treating physicians and the patient.


Bevacizumab Avastin Cancer Bowel perforation Metastasis Colorectal cancer Ovarian cancer Breast cancer Non-small cell lung cancer Glioma Renal cell carcinoma 


Papers of particular interest, published recently, have been highlighted as: •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  • Taher Abu-Hejleh
    • 1
  • James J. Mezhir
    • 2
  • Michael J. Goodheart
    • 3
  • Thorvardur R. Halfdanarson
    • 1
  1. 1.Department of Internal Medicine, Division of Hematology, Oncology, and Bone Marrow TransplantationThe University of Iowa Hospitals and ClinicsIowa CityUSA
  2. 2.Department of Surgery, Division of Surgical Oncology and Endocrine SurgeryThe University of Iowa Hospitals and ClinicsIowa CityUSA
  3. 3.Department of Gynecology and Obstetrics, Division of Gynecologic OncologyThe University of Iowa Hospitals and ClinicsIowa CityUSA

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