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open access
Case Report
Highlights
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- Ovarian cancer patients receiving bevacizumab treatment can experience significant adverse events.
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- We report a case of vertebral artery dissection associated with bevacizumab treatment.
Case history
The
patient is a 60-year-old woman with stage IIIC ovarian cancer who
underwent primary optimal cytoreductive surgery, including total
abdominal hysterectomy, bilateral salpingo-oophorectomy, omentectomy and
lymphadenectomy in 2010. She was then randomized to Arm I of GOG 252
and received a total of six cycles of dose dense weekly intravenous (IV)
paclitaxel 80 mg/m2 with IV carboplatin Area under Curve
(AUC) 6.0 every 21 days and IV bevacizumab 15 mg/kg every 21 days
starting with cycle 2. She completed an additional six cycles of
bevacizumab maintenance but was subsequently removed from the study due
to disease progression by both CA125 and computed tomographic (CT)
imaging. She was then started on oral cyclophosphamide 50 mg daily with
bevacizumab 10 mg/kg IV every 2 weeks and had a great response as
indicated by serial CA125 monitoring. Of note, the patient had a history
of chronic hypertension which preceded her diagnosis of her ovarian
cancer and was not exacerbated by her treatment with bevacizumab; her
blood pressures remained well controlled on stable doses of enalapril
and hydrochlorothiazide (HCTZ)......
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