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European Heart Journal Advance Access published online on September 1, 2008
European Heart Journal, doi:10.1093/eurheartj/ehn384
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

Bevacizumab treatment for cancer patients with cardiovascular disease: a double edged sword?

David Pereg and Michael Lishner*

Department of Internal Medicine A, Meir Medical Center, Kfar–Sava 44281, and Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel

Received 3 July 2008; accepted 25 July 2008.

* Corresponding author. Tel: 972 9 7472534, Fax: 972 9 7460781, Email: michael2{at}clalit.org.il

Recently, bevacizumab, the novel humanized monoclonal antibody directed against vascular endothelial growth factor (VEGF), has shown promising preclinical and clinical anti-cancer activity. However, concerns have been raised regarding a possible increased risk for arterial thrombo-embolic events associated with its administration, especially in patients with pre-existing cardiovascular disease. On the other hand, bevacizumab treatment is associated with an increased bleeding risk that may be augmented by the co-administration of anti-platelet drugs such as aspirin and clopidogrel. In this paper, we present the available data, identify controversies and unresolved issues, and suggest solutions regarding the administration of bevacizumab to cancer patients with cardiovascular disease.

Key Words: Bevacizumab • Thrombosis • Bleeding

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.


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