Why the study?
Does bevacizumab increase the risk of arterial thrombo-embolic events and bleeding in cancer patients with cardiovascular disease?
Does bevacizumab increase the risk of arterial thrombo-embolic events and bleeding in cancer patients with cardiovascular disease?
Bevacizumab poses a complex clinical challenge in cancer patients with cardiovascular disease due to competing risks of arterial thromboembolism and bleeding, particularly when co-administered with antiplatelet therapy.
Supports heightened vigilance for arterial events and bleeding with bevacizumab in cardiovascular patients; leaves open optimal antiplatelet strategies pending randomized data.
Recently, bevacizumab, the novel humanized monoclonal antibody directed against vascular endothelial growth factor (VEGF), has shown promising preclinical and clinical anti-cancer activity. However, concerns have been raised regarding a possible increased risk for arterial thrombo-embolic events associated with its administration, especially in patients with pre-existing cardiovascular disease. On the other hand, bevacizumab treatment is associated with an increased bleeding risk that may be augmented by the co-administration of anti-platelet drugs such as aspirin and clopidogrel. In this paper, we present the available data, identify controversies and unresolved issues, and suggest solutions regarding the administration of bevacizumab to cancer patients with cardiovascular disease.
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Pereg et al. (2008) studied this question.
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