P15.01 * Wound Healing Complications in Brain Tumor Patients on Bevacizumab
Year: 2014
Type: conference-abstract
Abstract: Bevacizumab (BV) is a monoclonal antibody against vascular endothelial growth factor A (VEGF-A) and is commonly used for treatment of recurrent glioblastoma (GBM). Wound healing problems are a well-established adverse event, which may be compounded by the concomitant use of corticosteroids. Here, we present two patients with GBM who developed wound healing complications while on chronic corticosteroids following BV treatment. Case 1: 61-year-old male diagnosed with a right frontal GBM in 2009. He was initially treated with standard chemoradiation. At first recurrence, he participated in a trial with cediranib and on second recurrence was started treatment with dexamethasone 4mg daily and BV 10 mg/kg every 2 weeks. After the 31st cycle of BV, he had trauma to left hand with significant bruising and tearing of skin after hitting his hand against a stair railing. Wound continued to expand and developed secondary infection requiring antibiotics (Abx) and debridement. BV was discontinued and wound slowly healed over period of 3 months. Case 2: 29-year-old male diagnosed with a right frontal anaplastic glioma. Initial treatment was external beam radiation and then temozolomide at recurrence 1 year later. A second focus of tumor was found in the cerebellum 3 years later and was treated with XRT requiring the use of chronic corticosteroids. During third recurrence, treatment started with BV 10 mg/kg every 2 weeks and continuation of corticosteroids. After 3 months of treatment with BV, existing abdominal striae that had developed from weight gain dehisced, resulting in a secondary infection with MRSA. Despite local wound care and Abx, the areas did not heal, and patient succumbed to the infection 2 months later. While post-surgical wound healing problems are well known issues with BV use, these cases demonstrate uncommon wound healing adverse events in patients on chronic corticosteroids treated with BV. Clinicians should be aware of the potential for these adverse events and future studies addressing wound care strategies are needed to help prevent this potentially serious complication.
Source: Neuro-Oncology
Authors: H. Ladha, T. Pawar, M. R. Gilbert, T. S. Armstrong
Institution: The University of Texas MD Anderson Cancer Center
Language: English
Subfield: Genetics
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2105301148