Dr. Mizrahi on Bevacizumab as a Chemoprotectant in CRC

Jonathan Mizrahi, MD, hematology/oncology fellow, The University of Texas MD Anderson Cancer Center, discusses bevacizumab (Avastin) as a chemoprotectant in colorectal cancer (CRC).

In October 2018, Mizrahi and Michael Overman, MD, of The University of Texas MD Anderson Cancer, published a study in Oncotarget on bevacizumab’s ability to reduce oxaliplatin-induced hepatic sinusoidal injury in patients with CRC. The study was done to see if there are certain therapies that, when added to oxaliplatin, could reduce the liver injury caused by oxaliplatin. Hepatic sinusoidal injury is often seen following hepatic resections of metastasectomies, a procedure that is often performed in patients with limited liver metastases, says Mizrahi.

Notably, in patients treated with preoperative bevacizumab and oxaliplatin, the rates of hepatic sinusoidal injury went down. These findings have led physicians to believe that bevacizumab can serve as a protectant against hepatic sinusoidal injury by way of VEGF inhibition and its interaction with reactive oxygen species. Patients who have hepatic sinusoidal injury have increased morbidity after they have liver resection with metastasectomy. If patients can receive bevacizumab preoperatively, the rate of morbidity associated with hepatic sinusoidal injury may decrease.