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Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report

Aflibercept is an antiangiogenic agent used in patients with metastatic colorectal cancer who have progressed to a first-line oxaliplatin-based regimen. The main adverse effects (AEs) of antiangiogenic agents are fatigue, asthenia, anorexia, hypertension, proteinuria, urinary tract infection, diarrh...

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Autores principales: Benitez Fuentes, Javier David, Lopez de Sa Lorenzo, Alfonso, Calvo Elias, Alberto Elpidio, Toledano Rojas, Carmen, Granja Ortega, Monica
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275094/
https://www.ncbi.nlm.nih.gov/pubmed/35836714
http://dx.doi.org/10.7759/cureus.26780
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author Benitez Fuentes, Javier David
Lopez de Sa Lorenzo, Alfonso
Calvo Elias, Alberto Elpidio
Toledano Rojas, Carmen
Granja Ortega, Monica
author_facet Benitez Fuentes, Javier David
Lopez de Sa Lorenzo, Alfonso
Calvo Elias, Alberto Elpidio
Toledano Rojas, Carmen
Granja Ortega, Monica
author_sort Benitez Fuentes, Javier David
collection PubMed
description Aflibercept is an antiangiogenic agent used in patients with metastatic colorectal cancer who have progressed to a first-line oxaliplatin-based regimen. The main adverse effects (AEs) of antiangiogenic agents are fatigue, asthenia, anorexia, hypertension, proteinuria, urinary tract infection, diarrhea, and neutropenia. Other AEs, such as hemorrhage, thromboembolic events, and gastrointestinal perforation, are much less frequent. Nasal septal perforation caused by antiangiogenic agents is even rarer. The published literature on this subject is scarce. Here, we report the case of a 54-year-old male with metastatic colorectal cancer undergoing treatment with leucovorin, fluorouracil (5-FU), irinotecan, and aflibercept who presented with epistaxis and nasal congestion. An otolaryngologist performed a rhinoscopy that revealed a perforation of the nasal septum. Aflibercept was withdrawn first, and local treatment was applied with lubricant and antibacterial lotions. It was considered a non-life-threatening side effect, and given the high risk of not continuing treatment in this patient with a recent recurrence, aflibercept was reintroduced in combination with leucovorin, 5-FU, and irinotecan. The patient continued local treatment and follow-up with medical oncology and otolaryngology with gradual improvement of symptoms. Follow-up was discontinued due to disease progression and death after 16 months of the event.
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spelling pubmed-92750942022-07-13 Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report Benitez Fuentes, Javier David Lopez de Sa Lorenzo, Alfonso Calvo Elias, Alberto Elpidio Toledano Rojas, Carmen Granja Ortega, Monica Cureus Oncology Aflibercept is an antiangiogenic agent used in patients with metastatic colorectal cancer who have progressed to a first-line oxaliplatin-based regimen. The main adverse effects (AEs) of antiangiogenic agents are fatigue, asthenia, anorexia, hypertension, proteinuria, urinary tract infection, diarrhea, and neutropenia. Other AEs, such as hemorrhage, thromboembolic events, and gastrointestinal perforation, are much less frequent. Nasal septal perforation caused by antiangiogenic agents is even rarer. The published literature on this subject is scarce. Here, we report the case of a 54-year-old male with metastatic colorectal cancer undergoing treatment with leucovorin, fluorouracil (5-FU), irinotecan, and aflibercept who presented with epistaxis and nasal congestion. An otolaryngologist performed a rhinoscopy that revealed a perforation of the nasal septum. Aflibercept was withdrawn first, and local treatment was applied with lubricant and antibacterial lotions. It was considered a non-life-threatening side effect, and given the high risk of not continuing treatment in this patient with a recent recurrence, aflibercept was reintroduced in combination with leucovorin, 5-FU, and irinotecan. The patient continued local treatment and follow-up with medical oncology and otolaryngology with gradual improvement of symptoms. Follow-up was discontinued due to disease progression and death after 16 months of the event. Cureus 2022-07-12 /pmc/articles/PMC9275094/ /pubmed/35836714 http://dx.doi.org/10.7759/cureus.26780 Text en Copyright © 2022, Benitez Fuentes et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Oncology
Benitez Fuentes, Javier David
Lopez de Sa Lorenzo, Alfonso
Calvo Elias, Alberto Elpidio
Toledano Rojas, Carmen
Granja Ortega, Monica
Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title_full Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title_fullStr Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title_full_unstemmed Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title_short Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With Aflibercept: A Case Report
title_sort perforation of the nasal septum in a colorectal cancer patient treated with aflibercept: a case report
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9275094/
https://www.ncbi.nlm.nih.gov/pubmed/35836714
http://dx.doi.org/10.7759/cureus.26780
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