Bevacizumab induced intestinal perforation in patients with colorectal cancer

Bevacizumab, a recombinant humanized monoclonal antibody targeting vascular endothelial growth factor, is an antiangiogenic agent approved for the treatment of multiple solid tumors. It has shown promise as a clinical agent against metastatic colorectal cancer, and particularly in combination with chemotherapy [1]. With increased use of bevacizumab, serious adverse effects are being reported more frequently, including hypertension, proteinuria, hemorrhage, thrombosis, fistula formation, and bowel perforation [24]. In two phase 3 trials of bevacizumab in colorectal cancer, intestinal perforation was an uncommon adverse event occurring at rates of only 1.5% and 1.1%, though serious and lethal. Here, the purpose of this study is to identify the clinical characteristics of intestinal perforation induced by bevacizumab in colorectal cancers.