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Risk of arterial thromboembolic events in patients with advanced colorectal cancer receiving bevacizumab


Tebbutt, NC and Murphy, F and Zannino, D and Wilson, K and Cummins, MM and Abdi, E and Strickland, AH and Lowenthal, RM and Marx, G and Karapetis, C and Shannon, J and Goldstein, D and Nayagam, SS and Blum, R and Chantrill, L and Simes, RJ and Price, TJ, (on behalf of the Australasian Gastro-Intestinal Trials Group), Risk of arterial thromboembolic events in patients with advanced colorectal cancer receiving bevacizumab, Annals of Oncology, 22, (8) pp. 1834-1838. ISSN 0923-7534 (2011) [Refereed Article]

Copyright Statement

Copyright 2011 The Author

DOI: doi:10.1093/annonc/mdq702


Background: Bevacizumab is an antiangiogenic mAb with efficacy against several cancers, but it is associated with risk of arterial thromboembolism (ATE). Further data are needed to determine the safety of bevacizumab.

Patients and methods: We recorded grade 3, 4, or 5 ATE events and other data (including age, baseline cardiovascular risk factors, history of ATE, and aspirin use) from 471 patients with metastatic colorectal cancer in the MAX (Mitomycin, Avastin, Xeloda) trial of capecitabine monotherapy versus capecitabine with bevacizumab with or without mitomycin C.

Results: Bevacizumab-treated patients had 12 grade 3, 4, or 5 ATEs (3.8% incidence). ATEs occurred in 2.1% of patients > 65 years, 5% of those with a history of ATE, and 5% of those with cardiac risk factors. Age, history of ATE, or vascular risk factors did not increase risk. Aspirin users had a higher incidence than nonusers (8.9% versus 2.7%) but had higher rates of vascular risk factors.

Conclusions: Bevacizumab was associated with a modestly higher risk of ATE, but safety was not significantly worse in older patients or patients with a history of ATE or vascular risk factors. The effect of aspirin in preventing ATE in patients receiving bevacizumab could not be determined from this study.

Item Details

Item Type:Refereed Article
Keywords:arterial thromboembolism, bevacizumab, chemotherapy, colorectal cancer, elderly
Research Division:Health Sciences
Research Group:Health services and systems
Research Field:Health services and systems not elsewhere classified
Objective Division:Health
Objective Group:Public health (excl. specific population health)
Objective Field:Preventive medicine
UTAS Author:Lowenthal, RM (Professor Ray Lowenthal)
ID Code:119256
Year Published:2011
Web of Science® Times Cited:31
Deposited By:Medicine
Deposited On:2017-07-28
Last Modified:2017-12-22

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