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• W1991403215 abstract "Le bevacizumab en première ligne, associé à une chimiothérapie à base de platine, améliore la survie des patients présentant un carcinome bronchique non à petites cellules non épidermoïdes métastatiques. L’AMM dans cette indication a été obtenue en 2007. Ce traitement présente des effets secondaires spécifiques en rapport avec son action anti angiogénique. À l’état physiologique, le VEGF est un facteur important du processus de cicatrisation. Le bevacizumab retarde la cicatrisation et peut favoriser les saignements. L’objectif de cet article est d’analyser les risques spécifiques lors des actes invasifs et d’émettre des recommandations pratiques. Malheureusement, les données de la littérature sont peu nombreuses. Nous nous appuierons donc essentiellement sur les études de chimiothérapie néoadjuvante dans le cancer colorectal métastatique avant métastasectomie hépatique et sur notre expérience dans les métastasectomies pulmonaires de tumeurs solides sous bevacizumab. Nous recommandons un délais de 2 jours entre la pose d’un Dispositif Veineux Implantable et le bevacizumab, un délais d’au moins 5 semaines entre la dernière injection de bevacizumab et une chirurgie invasive et un délais de 4 semaines entre une chirurgie invasive et l’initiation du bevacizumab. Le recours à une équipe médicochirurgicale rompue à la prise en charge de ce type de patients est bien évidemment recommandée. V. Gounant, B. Milleron, J. Assouad, J. Gligorov, A. Lavole, M. Wislez, E. Brian, B. Bazelly, D. Grunenwald As first line chemotherapy Bevacizumab, associated with a platinum based regime, improves survival in patients with metastatic, non small cell, non epidermoid bronchial carcinoma. Marketing authorization for this indication was obtained in 2007. This treatment produces specific secondary effects related to its anti-angiogenic action. Physiologically, vascular endothelial growth factor (VEGF) is important in the process of scar formation. Bevacizumab inhibits scar formation and may encourage bleeding. The aim of this article is to analyse the specific risks associated with invasive procedures and to produce practical recommendations. Unfortunately there are few data in the literature. We depend, therefore, principally on studies of neo-adjuvent chemotherapy in metastatic colo-rectal cancer prior to excision of hepatic metastases and on our own experience of excision of pulmonary metastases from solid tumours treated with bevacizumab. We recommend a delay of 2 days between implantation of an intravenous device and the initiation of bevacizumab, a delay of at least 5 weeks between the last injection of bevacizumab and invasive surgery and a delay of 4 weeks between surgery and the initiation of bevacizumab treatment. Obviously, referral to a medico-surgical team experienced in the management of these patients is strongly recommended." @default.
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• W1991403215 date "2009-02-01" @default.
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• W1991403215 title "Bevacizumab et actes invasifs : recommandations pratiques" @default.
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• W1991403215 doi "https://doi.org/10.1016/s0761-8425(09)71598-0" @default.
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