R C S Seet1, A A Rabinstein. 1. Mayo Clinic, Department of Neurology, W8B, 200 First Street SW, Rochester, MN 55905, USA. raymond_seet@nus.edu.sg
Abstract
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a potentially devastating complication of bevacizumab treatment. AIM: We examined the clinical features, treatment and outcomes of patients who developed PRES following bevacizumab treatment at our institution and those reported in the literature. DESIGN: Retrospective audit and systematic review. METHODS: Patients were identified from the Mayo Clinic database and the published literature using 'PubMed' and 'OVID' databases, from January 2006 to June 2010, who developed PRES features within 3 weeks of bevacizumab treatment, who had brain imaging findings of focal vasogenic edema and radiologic proof of reversibility. RESULTS: Two patients with definite PRES were identified from our institution and a further 10 cases were identified from the published literature (total, n=12). The mean age of these patients was 52 years (range 4-68 years), four of whom were men and eight women. Headaches (n=7), seizures (n=6), visual disturbances (n=5) and nausea and vomiting (n=3) were the common presenting symptoms. In a majority of patients (n=10), an increase in blood pressure from their baseline values was observed during their acute presentation. PRES resolved following withdrawal of bevacizumab and blood pressure control in all patients. CONCLUSIONS: PRES is a catastrophic neurological complication of bevacizumab treatment, which responds favorably to prompt bevacizumab withdrawal and blood pressure control.
BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a potentially devastating complication of bevacizumab treatment. AIM: We examined the clinical features, treatment and outcomes of patients who developed PRES following bevacizumab treatment at our institution and those reported in the literature. DESIGN: Retrospective audit and systematic review. METHODS:Patients were identified from the Mayo Clinic database and the published literature using 'PubMed' and 'OVID' databases, from January 2006 to June 2010, who developed PRES features within 3 weeks of bevacizumab treatment, who had brain imaging findings of focal vasogenic edema and radiologic proof of reversibility. RESULTS: Two patients with definite PRES were identified from our institution and a further 10 cases were identified from the published literature (total, n=12). The mean age of these patients was 52 years (range 4-68 years), four of whom were men and eight women. Headaches (n=7), seizures (n=6), visual disturbances (n=5) and nausea and vomiting (n=3) were the common presenting symptoms. In a majority of patients (n=10), an increase in blood pressure from their baseline values was observed during their acute presentation. PRES resolved following withdrawal of bevacizumab and blood pressure control in all patients. CONCLUSIONS: PRES is a catastrophic neurological complication of bevacizumab treatment, which responds favorably to prompt bevacizumab withdrawal and blood pressure control.
Authors: Christina A K Kim; Julie Price-Hiller; Quincy S Chu; Keith Tankel; Ron Hennig; Michael B Sawyer; Jennifer L Spratlin Journal: Invest New Drugs Date: 2014-05-23 Impact factor: 3.850