Complete pathological response to bevacizumab and chemoradiation in advanced rectal cancer. Nat Clin Pract Oncol 2007 May;4(5):316-21
Date
04/28/2007Pubmed ID
17464339Pubmed Central ID
PMC2686127DOI
10.1038/ncponc0813Scopus ID
2-s2.0-34247847960 (requires institutional sign-in at Scopus site) 50 CitationsAbstract
BACKGROUND: Localized rectal cancer responds well to 5-fluorouracil and radiation-based regimens. A phase I-II trial is currently testing the efficacy of adding bevacizumab, a VEGF-specific antibody, to standard chemoradiotherapy. The case presented here is a complete pathological response seen in a patient with extensive and locally invasive carcinoma after receiving this combined treatment.
INVESTIGATIONS: Physical examination, rectal ultrasound, PET-CT scan, laboratory tests, proctoscopic examination, chest radiograph, rectal forcep biopsies with immunohistochemistry, and protein and flow cytometric analyses.
DIAGNOSIS: Large, invasive, ultrasound stage T4 carcinoma of the rectum, which was positive for survivin.
MANAGEMENT: One 2-week cycle of bevacizumab alone, followed by 3 cycles of bevacizumab with continuous 5-fluorouracil infusion, and external-beam radiation therapy given 5 days per week to the pelvis, abdominoperineal resection with posterior vaginectomy, hysterectomy and bilateral salpingo-oophorectomy.
Author List
Willett CG, Duda DG, di Tomaso E, Boucher Y, Czito BG, Vujaskovic Z, Vlahovic G, Bendell J, Cohen KS, Hurwitz HI, Bentley R, Lauwers GY, Poleski M, Wong TZ, Paulson E, Ludwig KA, Jain RKAuthor
Kirk A. Ludwig MD Chief, Professor in the Surgery department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdenocarcinomaAngiogenesis Inhibitors
Antibodies, Monoclonal
Antibodies, Monoclonal, Humanized
Bevacizumab
Combined Modality Therapy
Drug Administration Schedule
Female
Humans
Middle Aged
Neoplasm Invasiveness
Rectal Neoplasms
Remission Induction
Treatment Outcome