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Anti-VEGF ATE — SCE Medical Oncology MCQ

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HardImmunotherapy & Targeted TherapyAnti-VEGF ATESCE Medical Oncology

A 60-year-old man with cancer develops an acute painful left lower limb with absent pulses. He is on bevacizumab. CT angiography shows left femoral artery occlusion. What is this complication?

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Correct answer: A — Arterial thromboembolism

Arterial thromboembolism (ATE: stroke, MI, peripheral arterial occlusion) is a recognised complication of anti-VEGF agents (bevacizumab: approximately 1-3% incidence). The mechanism involves endothelial dysfunction from VEGF pathway inhibition. Risk factors include: age >65, prior ATE, hypertension, diabetes. ATE is generally a contraindication to bevacizumab rechallenge (unlike VTE where continuation with anticoagulation is possible). Emergency vascular surgery is required for acute limb ischaemia.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer