A Case of Leg Ulcer Exacerbated after Bevacizumab Treatment

Abstract

 Bevacizumab is the first anti-vascular endothelial growth factor antibody approved for the treatment of solid tumors, and its indications have been expanding in recent years due to its excellent antitumor effects. However, because bevacizumab has a mechanism of action different from conventional anti-cancer drugs, adverse events associated with its use are distinctive, including wound healing complications.
 A 74-year-old female with hepatocellular carcinoma, diabetes mellitus, and hepatitis C visited our hospital due to worsening of a wound on the right lower leg after initiation of bevacizumab plus atezolizumab combination therapy. An ulcer with black necrosis on the front of the right lower leg and edema of the entire right lower leg were observed. Chemotherapy was discontinued because a wound healing complication due to bevacizumab was suspected. Thirty-five days after the final dose of bevacizumab, the patient underwent debridement and split-thickness skin graft surgery. The wound completely healed 3 months thereafter with conservative treatment.