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Recent Developments in Therapies and Strategies Against COVID-19
Published in Hanadi Talal Ahmedah, Muhammad Riaz, Sagheer Ahmed, Marius Alexandru Moga, The Covid-19 Pandemic, 2023
Misbah Hameed, M. Zia-Ul-Haq, Marius Moga
It has been long used as an antitumor drug. However, it may produce reversible myocardial toxicity or other associated dysfunction. Its use may result in hypertension; thus, blood pressure should be monitored during and after treatment with bevacizumab.
Optic Neuropathies Associated with Systemic Disorders And Radiation-Induced Optic Neuropathy
Published in Vivek Lal, A Clinical Approach to Neuro-Ophthalmic Disorders, 2023
Unfortunately, treatment of RION can be quite disappointing, with systemic corticosteroids and anticoagulation showing little benefit (36). Hyperbaric oxygen might offer some positive therapeutic effects if treatment is initiated within 72 hours of visual loss (28). Recently, bevacizumab, a recombinant human monoclonal antibody that blocks angiogenesis by inhibiting vascular endothelial growth factor A has shown promise in the treatment of radiation necrosis affecting the CNS and RION (37–39). Gonzalez et al. (39) demonstrated the benefit of using bevacizumab as monotherapy or bevacizumab with a chemotherapeutic agent (carboplatin, irinotecan, temozolomide) in 15 patients diagnosed with CNS radiation necrosis. Affected patients demonstrated improvement in both FLAIR and post-contrast T1-weighted MRI abnormalities. Torcuator et al. (40) described improvement in both FLAIR and contrast-enhanced T1 images in patients with biopsy-proven cerebral radiation necrosis. Levin et al. (41) enrolled 14 patients into a placebo-controlled, randomized, double-blind study to evaluate the effect of bevacizumab in treating CNS radiation necrosis. The MRI findings from this study showed that bevacizumab-treated patients demonstrated regression of necrotic lesions. Hence, there may be promise for the treatment of RION, which requires additional study. Given the devastating natural history of this condition, it may be reasonable to initiate therapy with bevacizumab, ideally at earliest point possible after diagnosis.
Chemotherapy in pregnancy
Published in Hung N. Winn, Frank A. Chervenak, Roberto Romero, Clinical Maternal-Fetal Medicine Online, 2021
Bevacizumab inhibits tumor angiogenesis by binding directly to vascular endothelial growth factor (VEGF). It is currently indicated for the treatment of glioblastoma, renal cell carcinoma, breast cancer, lung cancer, and colon cancer. Rabbit studies at human doses have demonstrated teratogeni-city including gross and skeletal malformations, as well as low fetal body weights and increased resorption. Reports on the use of this compound in human pregnancies are very limited. Petrou et al. described two early pregnancy losses at 6 weeks of gestation 7 and 10 days following intravitreal injection of bevacizumab (99). Rosen et al., however, reported the use of the therapy in the second trimester without significant fetal effects (100).
The protective effect of carvacrol on bevacizumab-related skin injury in rats: a biochemical and histopathological evaluation
Published in Cutaneous and Ocular Toxicology, 2022
Muge Gore Karaali, Soner Karaali, Damla Demir, Gulce Naz Yazıcı, Abdulkadir Coban, Renad Mammadov, Bahadır Suleyman, Halis Suleyman
Bevacizumab is the first anticancer drug approved for antiangiogenic therapy1. Bevacizumab is a recombinant humanized monoclonal antibody that specifically binds to vascular endothelial growth factor (VEGF) and inhibits all isoforms of human VEGF-A2. Bevacizumab binds to VEGF-A, preventing the interaction of VEGF-A with its receptors (VEGF), thereby inhibiting the activation of VEGF signalling pathways that promote neovascularization1. This inhibits tumour growth, progression, the formation of new vessels, tumour blood flow, regression of the nascent vasculature, and tumour metastasis2,3. Bevacizumab is frequently used for the treatment of some solid tumours, such as glioblastoma, colorectal, cervical, lung, renal-cell, and ovarian cancers, alone or in combination with the standard chemotherapy regimens4. Hypertension, fatigue, and gastrointestinal symptoms (diarrhoea, abdominal pain, etc.) are the most frequent adverse reactions to this agent1. Cutaneous reactions are also seen with substantial frequency. These side effects experienced by patients during treatment negatively impact their quality of life and may even require the interruption of their treatment5,6. Cutaneous ulcerations and necrosis, delayed wound healing, skin rash, perforating folliculitis, thrombogenic vasculopathy, and cutaneous bleeding are frequently reported cutaneous side effects during treatment with bevacizumab, but their causes are not clearly understood5–11.
Protein kinase inhibitors for the treatment of prostate cancer
Published in Expert Opinion on Pharmacotherapy, 2021
Vincent Chau, Ravi A. Madan, Jeanny B. Aragon-Ching
Despite being an antibody-based therapy, bevacizumab was included in this review due to its extensive testing. Early phase clinical testing showed essentially no monotherapy activity [36], but combination studies of bevacizumab with docetaxel showed a PSA response [37,38]. Further combination studies of bevacizumab with estramustine and docetaxel showed tolerability, but there was no comparison arm to determine whether this combination is efficacious [39]. Ultimately, the CALGB 90,401 trial showed that bevacizumab plus docetaxel and prednisone did not improve OS when compared to the placebo arm, but interestingly, PFS was improved [40]. Toxicity and treatment-related deaths were also increased in the bevacizumab group. This paradox suggests that there are additional molecular mechanisms that remain undiscovered but that could be potentially exploited for treatment of mCRPC when targeted along with anti-VEGF therapy. Despite no survival benefit, whether bevacizumab can be used in combination with chemotherapy to improve symptoms in prostate cancer remains to be seen.
Radiation-Induced Optic Neuropathy: Literature Review
Published in Neuro-Ophthalmology, 2021
Fabrício Gomes Ataídes, Samuel Flávio Braga Reis Silva, Julianna Joanna Carvalho Moraes De Campos Baldin
Bevacizumab (systemic anti-VEGF) has been administered intravenously at 7.5 mg/kg every 3 weeks for 12 months.77,78 It is believed to reduce radiation necrosis by decreasing capillary leakage and oedema.77 This drug was proven effective in a randomised clinical study for its use in radiation-related intracranial necrosis, which could justify its use in RION. Also, case reports have reported a significant improvement in visual acuity with its use.68,69,77,78 It can be administered intraocular (1.25 mg in 0.05 ml every 6 to 8 weeks, at least 2 initial injections), especially in cases of previous RION. A series of case reports, showed improvement of eye examination in all patients and visual acuity in most.69,79 Adverse effects from systemic administration of bevacizumab are rare and include cardiovascular (hypertension, thromboembolism), CNS (headache, pain syndromes, tumour recurrence), gastrointestinal (abdominal pain, nausea, vomiting, anorexia), haematological (haemorrhage, leukopaenia, neutropaenia), and musculoskeletal (weakness, myalgias) abnormalities.80–82