Dysphonia after Bevacizumab Rechallenge: A Case Report

Inhibition of vascular endothelial growth factor (VEGF) signaling, an initiator of tumor angiogenesis, inhibits tumor growth and invasion. Bevacizumab, a monoclonal antibody to VEGF, in common use as an adjunct to standard chemotherapy like irinotecan in advanced colorectal cancer, also affects the normal (nontumor) vasculature. Dysphonia or voice changes have been anecdotally reported in patients that have been exposed to antiangiogenics. In this case report, we present an occurrence of severe dysphonia in a 60-year-old male with metastatic colorectal cancer after reintroduction of irinotecan and bevacizumab. To our knowledge, this is the first case of dysphonia associated with bevacizumab rechallenge.