[Perforation of the nasal septum: a rare complication of bevacizumab]

Rev Mal Respir. 2012 Nov;29(9):1124-6. doi: 10.1016/j.rmr.2012.04.011. Epub 2012 Jul 31.
[Article in French]

Abstract

Introduction: Neovascularisation is a hallmark of cancer. Vascular endothelial growth factor (VEGF) is directly involved in the regulation of this tumoural neoangiogenesis, especially in lung cancer. Bevacizumab is a humanized monoclonal antibody targeting VEGF that is commonly used in thoracic oncology. Among the side effects, perforation of the nasal septum is rare.

Case report: We report the case of a 50-year-old woman with adenocarcinoma of the right upper lobe, immediately metastatic, treated with five cycles of chemotherapy (cisplatin, gemcitabine, bevacizumab). She developed a perforation of the nasal septum after the third injection of bevacizumab given as monotherapy during the maintenance phase.

Conclusions: This is, to our knowledge, the first description of this complication in the course of treatment of bronchial carcinoma. Its management is purely symptomatic. The action to be taken in using bevacizumab is not fully codified.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adenocarcinoma / complications
  • Adenocarcinoma / drug therapy
  • Angiogenesis Inhibitors / administration & dosage
  • Angiogenesis Inhibitors / adverse effects*
  • Angiogenesis Inhibitors / therapeutic use
  • Antibodies, Monoclonal, Humanized / administration & dosage
  • Antibodies, Monoclonal, Humanized / adverse effects*
  • Antibodies, Monoclonal, Humanized / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Bevacizumab
  • Cisplatin / administration & dosage
  • Deoxycytidine / administration & dosage
  • Deoxycytidine / analogs & derivatives
  • Erlotinib Hydrochloride
  • Fatal Outcome
  • Female
  • Gemcitabine
  • Glutamates / therapeutic use
  • Guanine / analogs & derivatives
  • Guanine / therapeutic use
  • Humans
  • Lung Neoplasms / complications
  • Lung Neoplasms / drug therapy
  • Maintenance Chemotherapy
  • Middle Aged
  • Nasal Septal Perforation / chemically induced*
  • Neoplasm Proteins / antagonists & inhibitors
  • Pemetrexed
  • Quinazolines / therapeutic use
  • Respiratory Insufficiency / etiology
  • Salvage Therapy
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal, Humanized
  • Glutamates
  • Neoplasm Proteins
  • Quinazolines
  • VEGFA protein, human
  • Vascular Endothelial Growth Factor A
  • Pemetrexed
  • Deoxycytidine
  • Bevacizumab
  • Guanine
  • Erlotinib Hydrochloride
  • Cisplatin
  • Gemcitabine