Yun Jina, Baek Grace, Indorf Amy, Duong Arianne
Pharmacy Department, Fred Hutchinson Cancer Center, University of Washington Medicine, Seattle, WA, USA.
J Oncol Pharm Pract. 2024 Apr 30:10781552241245037. doi: 10.1177/10781552241245037.
Bevacizumab is a monoclonal antibody that targets vascular endothelial growth factor, with a serious complication of wound healing complications. The package insert currently does not have recommendations on the management of bevacizumab administration around minor procedures, including port placements. Currently, there are only two trials that have examined the optimal timing of bevacizumab after port placement.
This is a single-center retrospective trial aiming to evaluate the rate of wound dehiscence and other port site complications depending on the time between port placement and bevacizumab infusion. Eligible patients who have had at least one port place and have received bevacizumab for an oncologic indication were identified in a study period of 1/1/2016-3/31/2021. The primary outcome of this study was the incidence of wound dehiscence in relation to the timing of bevacizumab infusion.
A total of 243 patients met the inclusion criteria, and 116 port placements had a port site complication. For wound dehiscence, 6% was observed 0 days from port placement, 10% was observed 1 day from port placement, 0% was observed 2 days from port placement, 0% was observed 3-7 days from port placement, 3% was observed 8-14 days from port placement, and 3% was observed 15-30 days from port placement.
The results of this study show an inverse relationship between the risk of wound dehiscence and port site complication and the timing of bevacizumab infusion to port placement, with an increase in absolute risk of wound dehiscence when bevacizumab is given within 2 days of port placement.
贝伐单抗是一种靶向血管内皮生长因子的单克隆抗体，具有伤口愈合并发症这一严重不良反应。目前药品说明书中没有关于在包括置入端口等小手术前后使用贝伐单抗的管理建议。目前仅有两项试验研究了置入端口后使用贝伐单抗的最佳时机。
这是一项单中心回顾性试验，旨在根据置入端口与输注贝伐单抗之间的时间来评估伤口裂开率和其他端口部位并发症。在2016年1月1日至2021年3月31日的研究期间，确定了至少有一次端口置入且因肿瘤适应证接受过贝伐单抗治疗的符合条件的患者。本研究的主要结局是与贝伐单抗输注时间相关的伤口裂开发生率。
共有243例患者符合纳入标准，116次端口置入发生了端口部位并发症。对于伤口裂开，端口置入后0天观察到的发生率为6%，1天为10%，2天为0%，3 - 7天为0%，8 - 14天为3%，15 - 30天为3%。
本研究结果表明，伤口裂开和端口部位并发症的风险与贝伐单抗输注至端口置入的时间呈负相关，在端口置入后2天内给予贝伐单抗时，伤口裂开的绝对风险增加。
