What are the side effects and harms of bevacizumab?

Bevacizumab (Bevacizumab), as a representative drug of anti-angiogenesis therapy, blocks tumor neovascularization by inhibiting the VEGF-A signaling pathway and has clear anti-cancer effects. However, at the same time, the anti-vascular mechanism of the drug may also affect the stability of normal tissue blood vessels. Therefore, the use of bevacizumab may cause a series of side effects, the severity and frequency of which require high attention from patients and doctors.

One of the common side effects is hypertension, which is caused by bevacizumab interfering with the vasodilation mechanism, resulting in increased vasoconstriction. Blood pressure needs to be monitored regularly in the early stages of use, and once it rises, antihypertensive drugs should be used to control it promptly to avoid further inducing cardiovascular events. Secondly, proteinuria and renal function damage are also common complications. Some patients experience increased glomerular permeability, resulting in increased protein in urine, and even develop nephrotic syndrome. Regular detection of urinary protein levels is required during treatment.

In terms of serious adverse reactions, bleeding and thrombotic events are of particular concern. Bevacizumab will weaken the stability of vascular endothelium and increase the risk of gastrointestinal bleeding, epistaxis, etc., especially when combined with anticoagulants, you need to be more cautious. In addition, it may cause serious complications such as venous thromboembolism, pulmonary embolism and even myocardial infarction. The risk is higher in the elderly or patients with underlying cardiovascular diseases.

Another side effect that cannot be ignored is delayed wound healing and risk of perforation, especially in patients after surgery or with gastrointestinal lesions. As VEGF inhibition leads to weakened neovascularization ability, thus delaying wound repair and even inducing gastrointestinal perforation. Therefore, surgical patients generally need to stop taking bevacizumab at least 4-6 weeks before surgery, and they also need to recover for a certain period of time after surgery before using it again.

In addition, some patients may also experience systemic adverse reactions such as fatigue, diarrhea, stomatitis, rash, or bone marrow suppression during medication. Although most of them are mild to moderate, they have a significant impact on the quality of life.

Reference materials:https://www.drugs.com/bevacizumab.html