the Oncologist: Characteristics of Oral Mucosal Events Related to Bevacizumab (Avastin) Treatment (study of 4 patients)

Background.
Bevacizumab, a monoclonal antibody targeting a vascular endothelial growth factor (VEGF) protein, has been reported to induce mucosal toxicities. However, the clinical characteristics of these particular toxicities have not been well characterized. We aimed at providing a detailed clinical description of signs and symptoms limited to the tongue mucosa in patients treated with bevacizumab.

Conclusion. These characteristic clinical findings are consistent with geographic tongue. However, large prospective evaluations are necessary to confirm this potential relationship. If bevacizumab is indeed associated with geographic tongue, increased awareness may result in improved reporting and characterization of this particular adverse event. 

"Asymptomatic geographic tongue does not necessitate
treatment or bevacizumab interruption, and patients should be
reassured about the benign nature and course of this condition.
Associated symptoms may be alleviated with topical anesthetic
agents, topical or systemic antihistamines, corticosteroids,
and anxiolytics [10, 11, 14]. Successful management
with topical tretinoin, systemic acitretin, vitamin A acid therapy,
and cyclosporin has also been reported in the non-oncologic
setting [11, 14]."