Case ReportPulmonary hypertension in two patients treated with bevacizumab for recurrent ovarian cancer
Section snippets
Case report 1
A 64-year-old Caucasian female with a history of hypertension, diabetes, and hypothyroidism was diagnosed with primary peritoneal carcinoma in December 2002. Over 3 years she was treated with multiple chemotherapies including carboplatin, paclitaxel, liposomal doxorubicin, tamoxifen and gemcitabine. In June 2006 she began bevacizumab and cyclophosphamide. Following her 26th cycle in January 2008 the patient was admitted with dyspnea and an oxygen saturation of 88%. A transthoracic
Case report 2
A 64-year-old Caucasian female without medical problems was diagnosed with stage IV ovarian cancer in May of 2000. She underwent surgery, carboplatin and paclitaxel and was in remission for 30 months. She subsequently received multiple regimens (carboplatin and paclitaxel; gemcitabine; and liposomal doxorubicin). She had a normal MUGA scan in February 2005.
In May 2005 she started bevacizumab 15 mg/kg every 3 weeks. After 3 courses she developed dyspnea with an oxygen saturation of 83% on room
Discussion
VEGF plays a role in the etiology of many respiratory disorders including acute lung injury, asthma, chronic obstructive sleep apnea, idiopathic pulmonary fibrosis, pleural disease and pulmonary hypertension [3]. Inhibition of VEGF receptors causes pulmonary hypertension via thickening of the medial layer of pulmonary arteries in animal models. Other studies suggest that VEGF protects endothelial cells from injury and apoptosis decreasing the risk of pulmonary hypertension. The cases reported
Conflict of interest statement
The authors declare that there are no conflicts of interest.
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