INTRODUCTIONThe aim of this study was to determine the effectiveness of intraocular injections of bevacizumab for neovascularisation of the iris and neovascular glaucoma.

CLINICAL PICTUREThree patients with neovascularisation of the iris due to various causes were recruited.

TREATMENTPatients were treated with intraocular bevacizumab.

OUTCOMENeovascularisation of the iris was noted to have completely regressed as early as 3 days after the injection and in all the patients (100%) within 8 days after injection. They were followed up for at least 1 month with no clinical evidence of recurrence. Visual acuity remained stable or improved, and the intraocular pressure was controlled in all the 3 patients' eyes. Vitreous haemorrhage also cleared. No signs of inflammation or complications were observed.

CONCLUSIONIntraocular injection of bevacizumab is effective and safe for patients with neovascularisation of the iris and neovascular glaucoma with or without vitreous haemorrhage.

Adult ; Aged ; Angiogenesis Inhibitors ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Glaucoma, Neovascular ; drug therapy ; Humans ; Iris ; blood supply ; Male

Adult ; Angiogenesis Inhibitors ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal ; administration & dosage ; therapeutic use ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Central Serous Chorioretinopathy ; drug therapy ; Humans ; Intravitreal Injections ; methods ; Male

Objective To investigate the clinical effects and safety of bevacizumab combined with S-1 as the second-line treatment of recurrent and/or metastatic esophageal cancer after chemoradiation. Methods Patients with recurrent or metastatic esophageal cancer after chemoradiation were treated with bevacizumab and S-1. Bevacizumab was used by intravenous infusion, 7.5mg/kg body weight on day 1; S-1 was used by oral at 80mg/m·d on day 1-14, 21 days as a cycle of treatment and repeated until either pro- gressive disease or intolerable toxicity occurred. Chest CT were performed and RECIST 1.1 was used for response evaluation. Kaplan-Meier method was used for survival analysis. Side effects were recorded and analyzed. Results Totally 78 patients were enrolled in the study, including 67 squamous cell carcinoma and 11 adenocarcinoma histologically. The overall response (CR+PR) rate was 22.4% (17/76) and disease control (CR+PR+SD) rate was 61.8% (47/76) respectively. The median follow-up time was 20 months (range from 9 to 44 months). The median progression-free survival (PFS) was 4.9 months (95% CI 4.4-5.5) and the median overall survival (OS) was 8.1 months (95% CI 7.6-9.2). The median PFS and OS of patients with metastasis diseases were 6.2 months (95% CI 3.3 to 6.3) and 8.5 months (95% CI 5.8 to 11.2), where PFS was longer than that of patients with local regional recurrence (median 5.0 months, 95% CI 3.0 to 5.5, P=0.017) and OS was longer than that of patients with regional disease and metastasis (median 8.0 months, 95% CI 4.6 to 9.5, P=0.010). The common adverse effects were mild to moderate neutropenia (84.2%), grade I-II hand and foot syndrome (51.3%), grade I-II nausea (48.7%), mild epistaxis (30.1%) and mild vomiting (14.5%). Esophageal bleeding occurred in 7.9% of patients. One patient (1.3%) died from massive bleeding which was caused by esophageal perforation. Conclusion Bevacizumab combined with S-1 was effective and safe for esophageal cancer patients who had recurrent or metastatic diseases after chemoradiation.
Adult ; Aged ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Bevacizumab ; administration & dosage ; adverse effects ; Drug Combinations ; Esophageal Neoplasms ; drug therapy ; mortality ; pathology ; Female ; Humans ; Male ; Middle Aged ; Oxonic Acid ; administration & dosage ; adverse effects ; Tegafur ; administration & dosage ; adverse effects

OBJECTIVETo evaluate the efficacy and safety of bevacizumab plus capecitabine in treating metastatic colorectal cancer(mCRC).

METHODSEleven patients with mCRC (6 females and 5 males) were enrolled in this study. Bevacizumab was given with 5 mg/kg every two weeks in five patients, 10 mg/kg every two weeks in four patients and 15 mg/kg every three weeks in two patients. All patients received capecitabine 2000 mg/m2 per day for 14 days.

RESULTSFive of 11 patients had partial response and five patients had stable disease and two patients had progressive disease. The disease control rate was 90.9%. The progress-free survival were 4 months and the median overall survival time were 15 months. The adverse events related to bevacizumab were grade 2 hypertension in 3 patients (27.3%) and grade 1 or 2 proteinuria in 4 patients (36.4%). Other adverse events such as mucositis, fatigue, subcutaneous haemorrhage were also observed. No thromboembolism or severe haemorrhage happened. No other grade 3 or 4 adverse events were observed.The adverse events in the combined therapy were hand-foot-syndrome (54.6%), diarrhea (27.3%), and neutropenia (18.2%), mainly due to capecitabine.

CONCLUSIONSThe combination of bevacizumab plus capecitabine has definite benefit in patients with mCRC. However,these benefits can not be maintained after the withdrawal of bevacizumab. The adverse drug reactions are well tolerated.

Aged ; Antibodies, Monoclonal, Humanized ; administration & dosage ; Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Bevacizumab ; Capecitabine ; Colorectal Neoplasms ; drug therapy ; Deoxycytidine ; administration & dosage ; analogs & derivatives ; Female ; Fluorouracil ; administration & dosage ; analogs & derivatives ; Humans ; Male ; Middle Aged ; Treatment Outcome

Colorectal cancer is the fourth most common malignant disease in Korea. Until recently, fluorouracil was the only effective chemotherapeutic agent for colorectal cancer. But during the past decades, the Food and Drug Administration (FDA) has approved four new drugs for advanced colorectal cancer. Two of them (irinotecan and oxaliplatin) are cytotoxic drugs, whereas the other two (bevacizumab and cetuximab) are monoclonal antibodies against molecular targets. Bevacizumab, a humanized antibody directed against the vascular endothelial growth factor, has been examined in combination with chemotherapeutic agents in several clinical trials in patients with advanced colorectal cancer. According to the phase III randomized controlled clinical trial, the addition of bevacizumab to IFL (irinotecan, 5-FU, leucovorin) led to an impressive, statistically significant increase in the rate of response and prolongation in median overall survival. Recently, a statistically significant prolongation in median survival was also reported with the addition of bevacizumab to FOLFOX4 (oxaliplain, 5-FU, leucovorin) regimen in patients with advanced colorectal cancer. Cetuximab is a monoclonal antibody against the epidermal growth factor receptor. It appears to be synergistic with irinotecan, even in irinotecan-refractory tumors. The most common side effect of cetuximab is acne-like rash, and interestingly, the development and severity of it have been correlated with an increased likelihood of an objective response. In the future, additional research will be required to define the optimal selection and scheduling of available cytotoxic and biologic treatment in individually tailored therapeutic strategies.
Antibodies, Monoclonal ; Bevacizumab ; Cetuximab ; Colorectal Neoplasms* ; Exanthema ; Fluorouracil ; Humans ; Korea ; Receptor, Epidermal Growth Factor ; United States Food and Drug Administration ; Vascular Endothelial Growth Factor A

PURPOSE: To compare the recurrence rates and complications associated with instillation of topical mitomycin C, cyclosporine, and bevacizumab after primary pterygium surgery. METHODS: Between July 2013 and June 2014, we performed surgery using the bare sclera method on 132 eyes (132 patients) with primary pterygium. We randomly selected 33 eyes (33 patients) and treated them with artificial tears four times a day for three months, 29 eyes (29 patients) were treated with topical 0.02% mitomycin C four times a day for five days, 34 eyes (34 patients) were treated with topical 0.05% cyclosporine four times a day for three months, and 36 eyes (36 patients) were treated with topical 2.5% bevacizumab four times a day for three months after surgery. We prospectively determined the recurrence rates of pterygium and complications at the six-month follow-up examination. RESULTS: At six months after surgery, the recurrence rates in each group were as follows: 45.5% (15 eyes) in the control group, 10.3% (three eyes) in the mitomycin C group, 20.6% (seven eyes) in the cyclosporine group, and 41.7% (15 eyes) in the bevacizumab group (p = 0.004). No serious complications, except subconjunctival hemorrhages, were observed in any group. CONCLUSIONS: Groups receiving topical 0.02% mitomycin C and 0.05% cyclosporine after surgery showed lower recurrence rates than the control group; however, no difference in recurrence rate was observed between the control group and the group receiving topical 2.5% bevacizumab after surgery.
Administration, Topical ; Aged ; Aged, 80 and over ; Alkylating Agents/administration & dosage ; Angiogenesis Inhibitors/administration & dosage ; Bevacizumab/*administration & dosage ; Cell Count ; Combined Modality Therapy ; Cyclosporine/*administration & dosage ; Double-Blind Method ; Endothelium, Corneal/pathology ; Female ; Humans ; Immunosuppressive Agents/administration & dosage ; Male ; Middle Aged ; Mitomycin/*administration & dosage ; Ophthalmic Solutions ; Ophthalmologic Surgical Procedures ; Prospective Studies ; Pterygium/diagnosis/*drug therapy/*surgery ; Recurrence ; Vascular Endothelial Growth Factor A/antagonists & inhibitors

PURPOSE: To analyze differences in the subfoveal choroidal thickness (SFChT) between bevacizumab responders (BevRs) and nonresponders (BevNRs) in patients with idiopathic central serous chorioretinopathy (CSC). METHODS: The medical records of 30 unilateral chronic CSC patients who were treated with intravitreal bevacizumab (IVB) as a first line treatment were reviewed. Patients were categorized as BevNRs when CSC did not completely resolve after a minimum of 3 IVB treatments. Enhanced depth imaging-optical coherence tomography was used and SFChT was measured before and after treatment. Choroidal hyperpermeability was also evaluated using indocyanine angiography. RESULTS: Twenty and 10 eyes were classified as BevRs or BevNRs, respectively. The mean number of IVB treatments was 2.22 +/- 0.89 in BevRs, and 4.80 +/- 1.03 in BevNRs. Compared with BevNRs, BevRs demonstrated significantly greater pretreatment SFChT (441.25 +/- 88.09 vs. 364.10 +/- 61.97 microm); SFChT reduction following IVB was significantly greater in BevRs than BevNRs. SFChT in the unaffected eyes was also greater in BevRs than BevNRs. Choroidal hyperpermeability was detected less frequently in BevNRs (hypofluorescence on late-phase, 0.0% and 33.3% in BevNRs and BevRs, respectively; p = 0.049). CONCLUSIONS: Compared with CSC eyes that did not respond well to IVB, BevRs demonstrated significantly thicker SFChT at baseline, greater reduction in SFChT after IVB treatment, and hyperfluorescence on late-phase indocyanine green angiography. We recommend IVB injection as the first-line therapy for CSC eyes with relatively high SFChT and hyperfluorescence on late-phase indocyanine green angiography.
Adult ; Angiogenesis Inhibitors/administration & dosage/*therapeutic use ; Bevacizumab/administration & dosage/*therapeutic use ; Central Serous Chorioretinopathy/*drug therapy/pathology ; Choroid/*pathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

PURPOSE: To analyze differences in the subfoveal choroidal thickness (SFChT) between bevacizumab responders (BevRs) and nonresponders (BevNRs) in patients with idiopathic central serous chorioretinopathy (CSC). METHODS: The medical records of 30 unilateral chronic CSC patients who were treated with intravitreal bevacizumab (IVB) as a first line treatment were reviewed. Patients were categorized as BevNRs when CSC did not completely resolve after a minimum of 3 IVB treatments. Enhanced depth imaging-optical coherence tomography was used and SFChT was measured before and after treatment. Choroidal hyperpermeability was also evaluated using indocyanine angiography. RESULTS: Twenty and 10 eyes were classified as BevRs or BevNRs, respectively. The mean number of IVB treatments was 2.22 +/- 0.89 in BevRs, and 4.80 +/- 1.03 in BevNRs. Compared with BevNRs, BevRs demonstrated significantly greater pretreatment SFChT (441.25 +/- 88.09 vs. 364.10 +/- 61.97 microm); SFChT reduction following IVB was significantly greater in BevRs than BevNRs. SFChT in the unaffected eyes was also greater in BevRs than BevNRs. Choroidal hyperpermeability was detected less frequently in BevNRs (hypofluorescence on late-phase, 0.0% and 33.3% in BevNRs and BevRs, respectively; p = 0.049). CONCLUSIONS: Compared with CSC eyes that did not respond well to IVB, BevRs demonstrated significantly thicker SFChT at baseline, greater reduction in SFChT after IVB treatment, and hyperfluorescence on late-phase indocyanine green angiography. We recommend IVB injection as the first-line therapy for CSC eyes with relatively high SFChT and hyperfluorescence on late-phase indocyanine green angiography.
Adult ; Angiogenesis Inhibitors/administration & dosage/*therapeutic use ; Bevacizumab/administration & dosage/*therapeutic use ; Central Serous Chorioretinopathy/*drug therapy/pathology ; Choroid/*pathology ; Female ; Humans ; Intravitreal Injections ; Male ; Middle Aged ; Retrospective Studies ; Treatment Outcome

BACKGROUNDIntravitreal anti-vascular endothelial growth factor (anti-VEGF) drugs and corticosteroids are being widely used to treat diabetic macular edema (DME). The purpose of this study was to evaluate further the efficacy and safety of intravitreal bevacizumab (IVB) alone in comparison with intravitreal bevacizumab combined with triamcinolone acetonide (IVB/IVT) in the treatment of DME.

METHODSPertinent publications were identified through CNKI, PubMed, Medline, EMBASE, and the Cochrane Controlled Trials Register up to November 30, 2013. Two investigators independently assessed the quality of the trials, and changes in central macular thickness (CMT) and best-corrected visual acuity (BCVA) were extracted at 6 weeks and 3, 6, 12, and 24 months after the initial treatment. A meta-analysis was carried out to compare the results between the groups receiving IVB and IVB/IVT using the software RevMan 5.0.

RESULTSA total of six randomized controlled trials (RCTs) were identified and included. The meta-analysis revealed that a significant reduction of the CMT was observed at 3 months after the initial treatment in the IVB/IVT group compared to the IVB group (P = 0.001). Also, changes in CMT at 6 weeks and 6, 12, and 24 months did not vary significantly between the IVB and IVB/IVT groups (P = 0.53, 0.76, 0.34, and 0.09, respectively). Similarly, changes in BCVA at 6 weeks and 3, 6, 12, and 24 months also did not vary significantly between the two groups (P = 0.66, 0.98, 0.81, 0.07, and 0.80, respectively). The results were robust to sensitivity analyses. However, the rate of intraocular pressure (IOP) rise after intravitreal injections varied significantly between the IVB and IVB/IVT groups (P < 0.01). A publication bias was not detected by funnel plots, the Egger method, or the Begg method.

CONCLUSIONS RESULTSof this meta-analysis showed that the treatments with IVB alone and combined IVB/IVT were similarly effective in improving the visual acuity, and, to some degree; combined IVB/IVT appeared to offer a marginal advantage over IVB in decreasing CMT in patients with DME. However, the addition of IVT resulted in intraocular pressure rise in some treated patients.

Antibodies, Monoclonal, Humanized ; administration & dosage ; therapeutic use ; Bevacizumab ; Diabetic Retinopathy ; drug therapy ; Humans ; Intravitreal Injections ; Macular Edema ; drug therapy ; Randomized Controlled Trials as Topic ; Triamcinolone Acetonide ; administration & dosage ; therapeutic use

BACKGROUNDNeovascular glaucoma (NVG) is a refractory disease which is difficult to manage. This study aimed at evaluating the efficacy and safety of adjunctive intravitreal bevacizumab (IVB) injection in conjunction with Ahmed glaucoma valve implantation (AGVI) in the management of NVG.

METHODSThis was a retrospective study of patients with NVG in whom AGVI was performed between October 2008 and May 2012. The sample was divided into two groups according to the pretreatment: with adjunctive IVB injection (the IVB group, n = 25 eyes) and without adjunctive IVB injection (the control group, n = 28 eyes). The surgical success rate, number of antiglaucoma medications used, best-corrected visual acuity (BCVA), postoperative complications, regression, and recurrence of iris neovascularization (NVI) were analyzed between the groups.

RESULTSThe surgical outcomes of the two groups were compared. The complete success rates in the IVB and control groups were 84.0% and 64.3% at 12 months and 80.0% and 53.6% at 18 months, respectively. There was a significant difference between the two groups (P = 0.041). Mean postoperative intraocular pressures, mean number of postoperative antiglaucoma medications, and BCVA were not significant between the two groups. The NVI in 22 (88.0%) eyes had completely regressed within 2 - 8 days after IVB. However, NVI recurred in 10 eyes (40.0%) 2 - 9 months later after IVB. The IVB group had only 1 case (4.0%) of hyphema out of 25 eyes, while there were 8 (28.6%) cases of hyphema out of 28 eyes in the control group (P = 0.026).

CONCLUSIONSThis study showed that preoperative IVB injection reduced NVI remarkably, decreased hyphema, and led to higher surgical success rates. Pre-operative IVB injection may be an effective adjunct to AGVI in the management of NVG.

Adult ; Aged ; Angiogenesis Inhibitors ; administration & dosage ; Antibodies, Monoclonal, Humanized ; administration & dosage ; Bevacizumab ; Female ; Glaucoma Drainage Implants ; adverse effects ; Glaucoma, Neovascular ; therapy ; Humans ; Intraocular Pressure ; Intravitreal Injections ; Male ; Middle Aged ; Prosthesis Implantation ; methods ; Retrospective Studies ; Visual Acuity