Patients on long-term maintenance therapy may encounter a variety of related and unrelated complications, and in that regard we asked about a phenomenon that is common with patients undergoing frequent imaging during follow-up — the detection of asymptomatic pulmonary emboli. Given the association of bevacizumab with such events, it is not surprising that about half the GOs would discontinue the agent, but it is enlightening to learn that the other half of respondents and both faculty members would not be deterred from continuing treatment in this situation.

Leighl NB et al. Bleeding events in bevacizumab-treated cancer patients who received full-dose anticoagulation and remained on study. Br J Cancer 2011;104(3):413-8. Abstract

Bennouna J et al. Continuation of bevacizumab after first progression in metastatic colorectal cancer (ML18147): A randomised phase 3 trial. Lancet Oncol 2013;14(1):29-37. Abstract

Koopman M et al. Final results and subgroup analyses of the phase 3 CAIRO3 study: Maintenance treatment with capecitabine + bevacizumab versus observation after induction treatment with chemotherapy + bevacizumab in metastatic colorectal cancer (mCRC). Proc ASCO 2014;Abstract 3504.

Koeberle D et al. Bevacizumab continuation versus no continuation after first-line chemo-bevacizumab therapy in patients with metastatic colorectal cancer: A randomized phase III noninferiority trial (SAKK 41/06). Proc ASCO 2013;Abstract 3503.