Avastin (bevacizumab): the new bisphosphonates?

Introduction: Bevacizumab or Avastin is a humanized monoclonal antibody that blocks vascular endothelial growth factor A, a key factor in angiogenesis. Avastin is indicated for metastatic colorectal, breast and renal cell carcinoma as well as glioblastoma and non small cell lung cancer. Bevacizumab is estimated to have been given to more than 800,000 patients with cancer worldwide to date. Data from clinical trials and case reports of adverse drug reactions identified 55 cases of ONJ (osteonecrosis of the jaw).

Aims: To identify the incidence of jaw osteonecrosis in patients on avastin chemotherapy from January 2009 to December 2010.

Methods: Patients on Avastin were identified via the hospital chemotherapy database. Demographic information, indication for use, and further medical diagnoses were identified. The hospital appointment system and case notes were examined to identify the patients who attended the oral & maxillofacial surgery department. Further data collection obtained information on patterns, presentation, treatment and outcome of patients with osteonecrosis of the jaw.

Results: 62 patients were treated with Avastin. 36 patients were female. The mean age was 59.7 (range 24–78). 29 were being treated for colo-rectal carcinoma and 21 patients for breast carcinoma. 32 patients were dead at the time of the analysis. One lady had osteonecrosis of the jaw in our cohort of patients.

Conclusions: The one case out of 62 to have osteonecrosis will be described. This is a higher incidence of ONJ than previously described; this in turn highlights the need for continual oral examination of patients receiving Avastin chemotherapy.

Conflict of interest: None declared.

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Feb 5, 2018 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Avastin (bevacizumab): the new bisphosphonates?
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