Endoscopic management of colonic perforation owing to angiogenesis inhibitors

Angiogenesis inhibitors have markedly improved, in combination with chemotherapy, the outcome of patients with metastatic solid tumors. Bevacizumab, the brand name of which is Avastin, is the first monoclonal antibody IgG1 used against the vascular endothelial growth factor involved in tumor proliferation. Gastrointestinal perforation is a well-known adverse event of bevacizumab therapy. Its surgical management is still controversial because of the high mortality rate of surgery. Here, we report a 48-year-old man with a history of metastatic renal cancer, who developed colonic perforation secondary to bevacizumab. This patient was treated successfully with endoscopic stenting.