A Fatal Brain Stroke in Patient with Advanced Breast Cancer Treated with Bevacizumab: A Case Report

Bevacizumab is a recombinant monoclonal antibody against vascular endothelial growth factor (VEGF) that is used to treat metastatic cancers of the colon, rectum, kidney, and breast. Its side effects include proteinuria, hypertension, gastrointestinal perforations, and arterial emboli. Although these toxic effects are more frequent in patients with atherosclerosis, their pathophysiology remains unresolved. We observed that patients treated with bevacizumab who developed hypertension had similar clinical presentations and biologic features, leading us to propose a unique mechanism for the vascular side effects of bevacizumab. We report a case of a woman treated for her metastatic breast cancer with first line chemotherapy with Paclitaxel plus bevacizumab who developed a brain stroke.