Bevacizumab Plus Direct Oral Anticoagulant Therapy in Ovarian Cancer Patients with Distal Deep Vein Thrombosis

  • Shinichi KomiyamaEmail author
  • Masaru Nagashima
  • Tomoko Taniguchi
  • Takayuki Rikitake
  • Mineto Morita
Short Communication


Background and Objective

Administration of bevacizumab to ovarian cancer patients with distal deep vein thrombosis (DVT) is problematic because of lack of evidence about the likely outcomes. We conducted a preliminary study in ovarian cancer patients with DVT who received bevacizumab combined with a direct oral anticoagulant (DOAC).


We retrospectively investigated patients with advanced or recurrent epithelial ovarian cancer and distal DVT diagnosed by ultrasonography who underwent chemotherapy containing bevacizumab (15 mg/kg every 3 weeks) combined with DOAC therapy.


Bevacizumab was administered to 88 patients, including 7 patients (7.9%) receiving concomitant DOAC therapy for distal DVT. In these 7 patients, the median body mass index was 21.3 kg/m2, median D-dimer level at diagnosis of DVT was 4.3 µg/mL, and median duration of DOAC therapy was 8 months. Adverse events during DOAC therapy were grade 1 epistaxis and grade 1 hemorrhoidal bleeding in one patient each. DVT resolved in four patients and was unchanged in three patients, with no central progression or secondary thromboembolism.


In ovarian cancer patients who have distal DVT, bevacizumab can possibly be administered safely when combined with a DOAC. To confirm this finding, further investigation on a larger scale will be required.



This work was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C) Grant Number JP18K09302.

Compliance with Ethical Standards


This work was supported by JSPS KAKENHI Grant-in-Aid for Scientific Research (C) Grant Number JP18K09302.

Conflict of interest

SK received speaker’s honoraria from Chugai Pharmaceutical. The other authors do not have any potential conflict of interest.

Ethical approval

This was a retrospective study and our institutional ethics committee waived formal assessment of the protocol.

Informed consent

This was a retrospective study and our institutional ethics committee waived the need to obtain informed consent.


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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Obstetrics and GynecologyToho University Faculty of MedicineTokyoJapan
  2. 2.Department of GynecologyToho University Ohashi Medical CenterTokyoJapan

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