Bevacizumab has more toxic in the era of ovarian cancer than colon cancer

Three of the phase III randomized trials (GOG-0218, OCEANS, and AURELIA) evaluating the role of bevacizumab in ovarian cancer used a dose of 15 mg/kg every 3 weeks. ICON7 used a dose of 7.5 mg/kg. Together, these independent phase III trials show a benefit in the dose range of 7.5 mg/kg to 15 mg/kg. The existing data suggest that at this time the main role of bevacizumab in the treatment of ovarian cancer may be in the setting of recurrent disease in combination with chemotherapy. However, bevacizumab is associated with some side effects. Gastrointestinal or spontaneous bowel perforations and delayed postoperative fistulae have been described for metastatic colorectal cancer. Few data are available on its use as a treatment for ovarian cancer. In this letter we report the first enterocutaneous fistula and rectovaginal fistula due to use of bevacizumab in the setting of platin refracter epithelial ovarian cancer.