{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T02:49:10Z","timestamp":1791254950363,"version":"4.1.0"},"reference-count":60,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2009,3,1]],"date-time":"2009-03-01T00:00:00Z","timestamp":1235865600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Ann Pharmacother"],"published-print":{"date-parts":[[2009,3]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To review the serious and common toxicities of bevacizumab and describe their incidence, risk factors, presentation, pathophysiology, and management.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources:<\/jats:title>\n                    <jats:p>Literature for this review article was collected from PubMed, MEDLINE, and the proceedings of the American Society of Clinical Oncology (2000\u2013November 2008). The key terms used in the search were: bevacizumab, vascular endothelial growth factor, angiogenesis inhibitors, toxicity, toxicity management, and adverse event.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Selection And Data Extraction:<\/jats:title>\n                    <jats:p>Review articles, preclinical studies, and all published Phase 1\u20133 clinical trials were reviewed. The references listed in identified articles were examined for additional publications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Synthesis:<\/jats:title>\n                    <jats:p>The biomedical literature from 2000 to 2008 confirms that bevacizumab carries serious and potentially life-threatening toxicity risks and emphasizes the importance of early recognition, continuous monitoring, and prompt management of these toxicities. Such toxicities include hemorrhage\/bleeding, wound healing complications, gastrointestinal perforation, arterial thromboembolism, congestive heart failure, hypertension, proteinuria\/nephrotic syndrome, infusion-related hypersensitivity reactions, and reversible posterior leukoencephalopathy syndrome. Patients at the highest risk for these toxicities are individuals with a history of hypertension, thromboembolism, bleeding, cardiovascular disease, or preexisting proteinuria, as these conditions may be exacerbated by bevacizumab use. Additionally, particular tumor types correlate with risk for individual toxicities; for example, patients with squamous non\u2013small-cell lung cancer or rectal cancer have a higher risk of bleeding, those with renal cell carcinoma have a higher proteinuria risk, and patients with colorectal cancer have a higher risk of gastrointestinal perforation. Further investigation is warranted to develop effective management strategies for these toxicities.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>As bevacizumab is becoming widely used in general oncology practice, it is important to understand the toxicities that can arise and to develop practice guidelines for their management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1345\/aph.1l426","type":"journal-article","created":{"date-parts":[[2009,3,3]],"date-time":"2009-03-03T22:57:59Z","timestamp":1236121079000},"page":"490-501","source":"Crossref","is-referenced-by-count":158,"title":["Intricacies of Bevacizumab-Induced Toxicities and Their Management"],"prefix":"10.1177","volume":"43","author":[{"given":"Sarah M","family":"Gressett","sequence":"first","affiliation":[{"name":"Advanced Practice Pharmacist, Veterans Affairs North Texas Health Care System, Dallas, TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin R","family":"Shah","sequence":"additional","affiliation":[{"name":"School of Pharmacy, Texas Tech University Health Services Center-Veterans Affairs North Texas Health Care System"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2009,3,3]]},"reference":[{"key":"bibr1-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra0706596"},{"key":"bibr2-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1038\/nm0603-669"},{"key":"bibr3-aph.1L426","doi-asserted-by":"publisher","DOI":"10.2325\/jbcs.968"},{"key":"bibr4-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1038\/nm0901-987"},{"key":"bibr5-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1038\/nm988"},{"key":"bibr6-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa032691"},{"key":"bibr7-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2005.05.112"},{"key":"bibr8-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2006.09.6305"},{"key":"bibr9-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.10.066"},{"key":"bibr10-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.15.4138"},{"key":"bibr11-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2004.11.022"},{"key":"bibr12-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa061884"},{"issue":"1","key":"bibr13-aph.1L426","first-page":"S6","volume":"94","author":"Miller KD","year":"2005","journal-title":"Breast Cancer Res Treat"},{"key":"bibr14-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61904-7"},{"key":"bibr15-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072113"},{"key":"bibr16-aph.1L426","volume-title":"Avastin (bevacizumab). 2006","author":"Package insert.","year":"2008"},{"key":"bibr17-aph.1L426","volume-title":"Avastin (bevacizumab)","author":"Package insert.","year":"2005"},{"key":"bibr18-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1159\/000088481"},{"key":"bibr19-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2001.19.3.843"},{"key":"bibr20-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.12009"},{"key":"bibr21-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.8043"},{"key":"bibr22-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.4104"},{"key":"bibr23-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.23.16_suppl.3554"},{"key":"bibr24-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2003.99.046"},{"key":"bibr25-aph.1L426","doi-asserted-by":"publisher","DOI":"10.2174\/157488408784293705"},{"key":"bibr26-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1002\/jso.20301"},{"key":"bibr27-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.4105"},{"key":"bibr28-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2005.23.16_suppl.3566"},{"key":"bibr29-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2006.24.18_suppl.3535"},{"key":"bibr30-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.15069"},{"key":"bibr31-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/djm086"},{"key":"bibr32-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.4026"},{"key":"bibr33-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1200\/jco.2008.26.15_suppl.4103"},{"key":"bibr34-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2004-01-0273"},{"key":"bibr35-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1161\/01.ATV.0000030186.66672.36"},{"key":"bibr36-aph.1L426","doi-asserted-by":"publisher","DOI":"10.1517\/14740338.5.4.553"},{"key":"bibr37-aph.1L426","unstructured":"The National Cancer Institute Common Toxicity Criteria (CTC) Version 2.0. 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