Reversible posterior leukoencephalopathy syndrome after bevacizumab/FOLFIRI regimen for metastatic colon cancer

Arch Neurol. 2006 Oct;63(10):1475-8. doi: 10.1001/archneur.63.10.1475.

Abstract

Objective: To describe a patient with reversible posterior leukoencephalopathy syndrome following the administration of bevacizumab (Avastin), a monoclonal antibody against vascular endothelial growth factor.

Design: Case report/literature review.

Setting: University hospital.

Patient: A 52-year-old man receiving chemotherapy for stage IV rectal carcinoma.

Results: Clinical and radiographic evidence consistent with reversible posterior leukoencephalopathy syndrome was found following the administration of irinotecan hydrochloride, leucovorin calcium, and fluorouracil (FOLFIRI) regimen chemotherapy and bevacizumab.

Conclusions: Reversible posterior leukoencephalopathy syndrome following treatment with angiogenesis modulators can occur. In addition to raising clinical suspicion in appropriate patients, this report may yield clues to the pathophysiologic underpinnings of reversible posterior leukoencephalopathy syndrome.

Publication types

  • Case Reports

MeSH terms

  • Angiogenesis Inhibitors / adverse effects
  • Antibodies, Monoclonal / adverse effects*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Combined Chemotherapy Protocols / adverse effects*
  • Aphasia / chemically induced
  • Aphasia / physiopathology
  • Bevacizumab
  • Blindness, Cortical / chemically induced
  • Blindness, Cortical / physiopathology
  • Blood Vessels / drug effects
  • Blood Vessels / physiopathology
  • Camptothecin / adverse effects
  • Camptothecin / analogs & derivatives
  • Carcinoma / blood supply
  • Carcinoma / drug therapy*
  • Carcinoma / secondary
  • Cognition Disorders / chemically induced
  • Cognition Disorders / physiopathology
  • Colonic Neoplasms / blood supply
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / pathology
  • Dementia, Vascular / chemically induced*
  • Dementia, Vascular / physiopathology
  • Fluorouracil / adverse effects
  • Humans
  • Leucovorin / adverse effects
  • Liver Neoplasms / blood supply
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / secondary
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / drug therapy
  • Neovascularization, Pathologic / physiopathology
  • Occipital Lobe / drug effects*
  • Occipital Lobe / pathology
  • Occipital Lobe / physiopathology
  • Parietal Lobe / drug effects
  • Parietal Lobe / pathology
  • Parietal Lobe / physiopathology
  • Vascular Endothelial Growth Factor A / antagonists & inhibitors
  • Vascular Endothelial Growth Factor A / metabolism

Substances

  • Angiogenesis Inhibitors
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Vascular Endothelial Growth Factor A
  • Bevacizumab
  • Leucovorin
  • Fluorouracil
  • Camptothecin

Supplementary concepts

  • IFL protocol