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Tolerability of Antiangiogenic Therapy
Compared with conventional chemotherapy, angiogenesis inhibitors are generally well tolerated and are associated with fewer treatment interruptions and discontinuations due to side effects. Nevertheless, they are associated with a number of side effects that require monitoring and management by health professionals. One side effect may be elevated blood pressure (hypertension). This side effect can usually be managed with standard blood pressure lowering medications. Because angiogenesis is an important healing mechanism following a heart attack, cancer patients with pre-existing heart conditions receiving an antiangiogenic drug should have their heart function monitored while on therapy.

Another side effect of antiangiogenic cancer therapy may be excess protein in the urine, called proteinuria. This condition is usually mild and temporary and resolves with discontinuation of treatment. Other side effects reported with use of angiogenesis inhibitors have included impaired wound healing, bleeding (usually nosebleeds), and blood clots.

A less common but serious side effect of antiangiogenic cancer therapy is the development of a hole or perforation in the bowel. The risk for bowel perforation appears to be slightly increased among ovarian cancer patients receiving bevacizumab than in other types of cancer. Ovarian cancer patients who have tumors extending into the bowel wall, have had prior bowel surgery to remove a tumor, have a tumor obstructing the bowel, or who have been treated with 3 or more lines of chemotherapy prior to receiving bevacizumab may have an increased risk for bowel perforation21, 22.


Last updated July 5, 2011