The safety profile of
bevacizumab (BV) remains a challenging issue, in particular its role in fragile OC patients. Areas covered: In this literature review, we have analyzed safety data from Phase III trials evaluating the combination of BV plus standard
chemotherapy in advanced or recurrent OC patients. In particular, our review aimed at clarifying the impact of the
drug on fragile patients, and the correlation between BV and postoperative complications after
cytoreductive surgery. Expert opinion: The addition of BV to standard
chemotherapy regimens may cause unexpected side effects such as
hypertension or
proteinuria in up to 10% of women receiving the
drug. BV administration is not associated with increase postoperative complications after
cytoreductive surgery. Artero-
venous thromboembolism and gastrointestinal perforation/
fistula occurring in around 3% of OC patients treated with BV represent life-threatening events always requiring
drug suspension. A closer monitoring is required in selected groups of women including: women with
inflammatory bowel disease, or uncontrolled
hypertension. Age itself is not a major
contraindication, but older women should be carefully evaluated prior to start the
drug. Finally, BV maintenance
therapy should not be prematurely stopped due to minor events, since
drug suspension may reduce survival.