Toxicities Profile of Bevacizumab in Cancer Patients Treated in a Tertiary Care Cancer Institute

Abstract

Introduction: Bevacizumab, a recombinant humanized monoclonal antibody against vascular endothelial growth factor (VEGF), inhibits tumor growth by blocking angiogenesis. Bevacizumab was approved in common solid tumors with high therapeutic need. Overall, bevacizumab is generally well tolerated. Some side effects can be fatal, its critical to determine risk factors, toxicity profile and set up treatment plans to reduce treatment related morbidity and death. The present study aims to assess side effects of bevacizumab mainly hypertension,proteinuria and hepatotoxicity. Material and Methods: About 25 patients treated with bevacizumab for a time period of 3 months from January 25th to March 25th in the year 2025 were recruited between age group of 18 to 60 years. People unwilling to sign the informed consent form and people who are not showing up on time for therapy or evaluation were excluded in this study. Urine sample were collected for the evaluation of proteinuria, blood sample for checking transaminitis and regular mesearement of blood pressure for hypertension evaluation. All the toxicity were assessed according to CTCAE. Results: The study shows that bevacizumab is associated with a significantly increased risk of proteinuria and hypertension in patients who received treatment for metastatic cancers of the lung, hepatocellular, gastroesophageal, colorectal, and ovarian. Over 40% of patients show hypertension either as a new onset (20%) or exacerbation of previous hypertension (80%). About 28% of patients had mild or moderate proteinuria, high grade proteinuria was found in only 4% of patients and none of our patient had advanced to nephrotic syndrome. No liver toxicity as all the alanine aminotransferase and aspartate aminotransferase levels were within normal range. Conclusion: The administration of bevacizumab requires disclosure of the risks and the benefits and alternative therapies to patients in an informed consent-like process. With evolving precision oncology the role of bevacizumab continuous to grow and care givers should be aware of the toxicities of the drug.