PMID- 35836714
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220716
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 14
IP  - 7
DP  - 2022 Jul
TI  - Perforation of the Nasal Septum in a Colorectal Cancer Patient Treated With 
      Aflibercept: A Case Report.
PG  - e26780
LID - 10.7759/cureus.26780 [doi]
LID - e26780
AB  - Aflibercept is an antiangiogenic agent used in patients with metastatic 
      colorectal cancer who have progressed to a first-line oxaliplatin-based regimen. 
      The main adverse effects (AEs) of antiangiogenic agents are fatigue, asthenia, 
      anorexia, hypertension, proteinuria, urinary tract infection, diarrhea, and 
      neutropenia. Other AEs, such as hemorrhage, thromboembolic events, and 
      gastrointestinal perforation, are much less frequent. Nasal septal perforation 
      caused by antiangiogenic agents is even rarer. The published literature on this 
      subject is scarce. Here, we report the case of a 54-year-old male with metastatic 
      colorectal cancer undergoing treatment with leucovorin, fluorouracil (5-FU), 
      irinotecan, and aflibercept who presented with epistaxis and nasal congestion. An 
      otolaryngologist performed a rhinoscopy that revealed a perforation of the nasal 
      septum. Aflibercept was withdrawn first, and local treatment was applied with 
      lubricant and antibacterial lotions. It was considered a non-life-threatening 
      side effect, and given the high risk of not continuing treatment in this patient 
      with a recent recurrence, aflibercept was reintroduced in combination with 
      leucovorin, 5-FU, and irinotecan. The patient continued local treatment and 
      follow-up with medical oncology and otolaryngology with gradual improvement of 
      symptoms. Follow-up was discontinued due to disease progression and death after 
      16 months of the event.
CI  - Copyright (c) 2022, Benitez Fuentes et al.
FAU - Benitez Fuentes, Javier David
AU  - Benitez Fuentes JD
AD  - Health Research Institute of the Hospital Clinico San Carlos (IDISSC), Hospital 
      Clinico San Carlos, Madrid, ESP.
AD  - Medical Oncology, Hospital Clinico San Carlos, Madrid, ESP.
FAU - Lopez de Sa Lorenzo, Alfonso
AU  - Lopez de Sa Lorenzo A
AD  - Medical Oncology, Hospital Clinico San Carlos, Madrid, ESP.
FAU - Calvo Elias, Alberto Elpidio
AU  - Calvo Elias AE
AD  - Internal Medicine, Hospital Clinico San Carlos, Madrid, ESP.
FAU - Toledano Rojas, Carmen
AU  - Toledano Rojas C
AD  - Medical Oncology, Hospital Clinico San Carlos, Madrid, ESP.
FAU - Granja Ortega, Monica
AU  - Granja Ortega M
AD  - Medical Oncology, Hospital Clinico San Carlos, Madrid, ESP.
LA  - eng
PT  - Case Reports
DEP - 20220712
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9275094
OTO - NOTNLM
OT  - a case report
OT  - adverse event
OT  - aflibercept
OT  - antiangiogenic drug
OT  - colorectal cancer
OT  - nasal septum perforation
OT  - skin and mucosal toxicity
COIS- The authors have declared that no competing interests exist.
EDAT- 2022/07/16 06:00
MHDA- 2022/07/16 06:01
PMCR- 2022/07/12
CRDT- 2022/07/15 02:28
PHST- 2022/07/12 00:00 [accepted]
PHST- 2022/07/15 02:28 [entrez]
PHST- 2022/07/16 06:00 [pubmed]
PHST- 2022/07/16 06:01 [medline]
PHST- 2022/07/12 00:00 [pmc-release]
AID - 10.7759/cureus.26780 [doi]
PST - epublish
SO  - Cureus. 2022 Jul 12;14(7):e26780. doi: 10.7759/cureus.26780. eCollection 2022 
      Jul.