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Colorectal Cancer Case Studies

Charles Fuchs, MD: Bevacizumab Plus Chemotherapy

Charles Fuchs, MD
Published Online:Apr 27, 2016
Case 1 examines a 68-year-old man was diagnosed with advanced, unresectable colon cancer has just started treatment with FOLFIRI plus bevacizumab.

Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 1

Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 1
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 2
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 1
Unresectable Colon Cancer with Charles Fuchs, MD and Tanios Bekaii-Saab, MD: Case 2


Why would you choose to add bevacizumab to a chemotherapy regimen?

The data are pretty compelling. You significantly add to the efficacy of standard chemotherapies by adding bevacizumab to chemotherapy. Moreover, the tolerability of adding bevacizumab is really exceptional. It adds very little in the way of toxicity, so in quality of life you lose nothing. Patients I think tolerate the antibody so well, and given its benefit, I would routinely add bevacizumab to first-line chemotherapy. 

There are a few rare circumstances where you might not add bevacizumab, namely if there's a risk of perforation or if the patient has a fistula from the surgery, you wouldn't want to give bevacizumab within 4 weeks of surgery. So if you're starting chemotherapy shortly after surgery, you might delay adding bevacizumab until 4 weeks have transpired.

Lastly, for patients who have active cardiovascular issues, you might not consider adding bevacizumab in that circumstance. I think those are the rare circumstances. The majority of patients are reasonable candidates for bevacizumab added to their first-line chemotherapy.

Unresectable Colon Cancer: Case 1

68-year-old man was diagnosed with advanced, unresectable colon cancer has just started treatment with FOLFIRI plus bevacizumab.

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