Critical Role of Anti-angiogenesis And Vegf Inhibition in by E. Díaz-Rubio, H.-J. Schmoll

By E. Díaz-Rubio, H.-J. Schmoll

Complement factor: Oncology 2005, Vol. sixty nine, Suppl. three

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Extra resources for Critical Role of Anti-angiogenesis And Vegf Inhibition in Colorectal Cancer (Supplement Issue: Oncology 2005)

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J Clin Oncol 2005;23:792–799. 32 Hambleton J, Novotny WF, Hurwitz H, Fehrenbacher L, Cartwright T, Hainsworth J, Heim W, Berlin J, Kabbinavar F, Holmgren E: Bevacizumab does not increase bleeding in patients with metastatic colorectal cancer receiving concurrent anticoagulation. J Clin Oncol 2004;22(suppl):abstract 3528. 33 Fyfe GA, Hurwitz H, Fehrenbacher L, Cartwright T, Cartwright J, Heim W, Berlin J, Kabbinavar F, Holmgren E, Novotny W: Bevacizumab plus irinotecan/5-FU/leucovorin for treatment of metastatic colorectal cancer results in survival benefit in all pre-specified patient subgroups.

However, it seems likely that it may be related to inhibition of VEGF by bevacizumab, which is known to decrease the production of nitric oxide [23]. Nitric oxide is a known vasodilator, and therefore decreased production due to VEGF inhibition would result in vasoconstriction and increased blood pressure. This specific mechanism for bevacizumab-related hypertension fits with the fact that hypertension resolves in most patients once bevacizumab therapy is withdrawn. It is also interesting to note that hypertension appears to be a class effect of agents targeting the VEGF pathway and has been observed with a number of such agents [24–26].

6 vs. 4 months) [21]. The authors state that irinotecanbased therapy may be preferable to avoid any neurotoxicity associated with the oxaliplatin regimen. 3 vs. 165) [22]. In contrast, in a recent phase III trial of irinotecan plus high-dose folinic acid/5-FU (IFIFAFU) versus oxaliplatin plus high-dose folinic acid/5-FU (OXAFAFU) (n = 274), the OXAFAFU regimen was more ac- Bevacizumab in CRC Oncology 2005;69(suppl 3):34–45 Chemotherapy Options for Metastatic CRC The development of new chemotherapies has improved survival in metastatic CRC, but the optimal treatment strategy remains to be defined, particularly the best sequence of drug administration [6].

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