Intraperitoneal VEGF Inhibition Using Bevacizumab: A Potential Approach for the Symptomatic Treatment of Malignant Ascites? -- The Oncologist

"Despite the very strong preclinical evidence for an obligatory role of VEGF in the formation of malignant ascites and for a possible therapeutic efficacy of anti-VEGF therapies in the setting of malignant effusions, there are currently no reports from clinical studies addressing this point in cancer patients..........To date, only very few patients with malignant ascites have received i.p. bevacizumab and, therefore, this route of administration as well as this particular patient population need to be examined stringently regarding the safety of the treatment. However, we believe that i.p. application might be the route of choice in this particular setting."

Note: this review references 5 different papers for a total of 17 patients including ovarian cancer patients. One study note ascites relief in all patients - reference: El-Shami K, Elsaid A, El-Kerm Y. Open-label safety and efficacy pilot trial of intraperitoneal bevacizumab as palliative treatment in refractory malignant ascites. J Clin Oncol 2007;25(18 suppl):9043.