RT Journal Article
SR Electronic
T1 Ambiguous effects of anti-VEGF monoclonal antibody (bevacizumab) for POEMS syndrome
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 1346
OP 1348
DO 10.1136/jnnp-2012-304874
VO 84
IS 12
A1 Yukari Sekiguchi
A1 Sonoko Misawa
A1 Kazumoto Shibuya
A1 Saiko Nasu
A1 Satsuki Mitsuma
A1 Yuta Iwai
A1 Minako Beppu
A1 Setsu Sawai
A1 Shoichi Ito
A1 Shigeki Hirano
A1 Chiaki Nakaseko
A1 Satoshi Kuwabara
YR 2013
UL http://jnnp.bmj.com/content/84/12/1346.abstract
AB Objective Vascular endothelial growth factor (VEGF) plays an essential role in the pathophysiology of polyneuropathy, organomegaly, endocrinopathy, M-protein and skin changes (POEMS) syndrome. Anti-VEGF antibody (bevacizumab) appears to be an attractive therapeutic option. The aim of this study is to investigate the effects of bevacizumab for patients with POEMS syndrome. Methods We reported six POEMS patients treated with bevacizumab and reviewed the literature. Results The serum VEGF levels decreased immediately after bevacizumab administration in all six patients. However, four patients had entirely no clinical response, and two of them died. The remaining two showed improvement that could be explained by combined treatments. We also reviewed the literature and found 11 patients treated with bevacizumab; of these, only one was treated with bevacizumab alone. 10 had combined treatments, and four died without any response. Conclusions Both our experience and the literature suggest ambiguous effects of bevacizumab; inhibition of VEGF alone may be insufficient because multiple cytokines are upregulated, or aberrant neo-vascularization may have already fully developed in the advanced stage of POEMS syndrome.