Source: Medscape Today Treatment-Related Mortality With Bevacizumab in Cancer Patients: A Meta-analysis Study Summary Although bevacizumab has been shown to improve survival in patients with a variety of solid tumors when added to conventional chemotherapy, it has also been associated with life-threatening and fatal adverse events (FAEs), including bleeding, thromboembolism, and perforation. This improvement in survival has led to the assumption that FAEs are rare and do not significantly affect patients who are receiving treatment. In this large meta-analysis, Ranpura and colleagues identified 10,217 patients with various solid tumors from 16 randomized studies, as follows: Colorectal cancer (5 studies); Non-small cell lung cancer (4 studies); Breast cancer (3 studies); Renal cell cancer (2 studies); Pancreatic cancer (1 study); and Prostate cancer (1 study). A clear increase in FAEs was evident in patients who received bevacizumab compared with those who received standard chemotherapy alone (2.5% vs 1.7%; relative risk [RR] 1.46; P = .01). This association varied with chemotherapy agents but not with tumor type. In particular, FAEs occurred in patients receiving taxanes or platinum agents (RR 3.49; 3.3% vs 1%) but not with other specific agents. Types of FAEs included bleeding (23.5%), gastrointestinal perforation (7.1%), and pulmonary embolism and stroke (5.1% each). Most fatal bleeding events were pulmonary or gastrointestinal in origin. Viewpoint The benefit of bevacizumab is under increased scrutiny given the latest data in patients with metastatic breast cancer. In this large meta-analysis, Ranpura and colleagues documented a clear increase in the rate of FAEs (2.5%) in patients [...]