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Tolerability of Antiangiogenic Therapy
Side effects of antiangiogenic cancer treatments are typically much milder and less debilitating than those of conventional chemotherapy agents. Elevated blood pressure (hypertension) is the most common side effect of bevacizumab treatment, and is treated with standard blood pressure medications. Other side effects of bevacizumab may include excess protein in the urine and mild blood clotting or bleeding problems. For this reason, bevacizumab must be used with caution in patients taking blood thinners. Much less frequently, patients on bevacizumab have experienced serious bleeding events, blood clots, impaired wound healing, bowel perforation, and kidney failure. Rarely, congestive heart failure has been reported in breast cancer patients treated with bevacizumab following or together with anthracycline chemotherapy.17

Side effects from oral antiangiogenic agents include diarrhea, fatigue, nausea, high blood pressure, and inflammation of the mucous membranes. Sunitinib and sorafenib can cause a number of skin toxicities, including painful calluses on the soles of the feet and palms of the hands, changes in hair color and texture, and small hemorrhages under the fingernails.18 Patients on sunitinib may require monitoring of thyroid function and for certain heart rhythm abnormalities.19, 20


Last updated May 29, 2011