Health Canada advisory: Avastin linked to ‘flesh-eating disease’
The Hoffmann-La Roche Limited (Roche) cancer drug, Avastin (bevacizumab), has been linked to rare occurrences of the “flesh-eating disease”, necrotizing fasciitis, according to a Health Canada advisory issued May 2.
AVASTIN is used either alone to treat a particular type of brain cancer (glioblastoma), or in combination with chemotherapy to treat cancers that have spread to other parts of the body such as colon, rectal and lung cancer.
Avastin’s manufacturer, Hoffmann-La Roche Ltd., says it has identified 52 patients worldwide who developed necrotizing fasciitis while taking Avastin between November 1997 and September 2012.
Two of these infections occurred in Canada, including in one patient who died.
According to the advisory, necrotizing fasciitis is a severe, life-threatening bacterial infection of the skin and soft tissue (tissue other than bone and cartilage). It has been reported, in rare cases, in patients treated with AVASTIN. Some of these patients have died from complications of necrotizing fasciitis.
Symptoms can develop quickly, as early as 24 hours after a minor skin injury or surgical wound, and may include: sudden, severe pain in the affected area, fever, redness, heat, swelling, or fluid-filled blisters in the skin, scaling, peeling, or discolored skin over the affected area. Other symptoms may include confusion, fainting or dizziness.
People who have diabetes or cancer have a greater risk of developing necrotizing fasciitis because their immune system responses are lowered.
Dr. Malcolm Moore of the Princess Margaret Cancer Centre tells CTV News, Avastin helps extend the survival of patients with metastatic colon cancer because it helps prevent the formation of new blood vessels in tumors.
Moore notes that patients taking Avastin are usually also taking other chemotherapy drugs that suppress the immune system, making it easier for the flesh-eating bacteria to take hold.
“Many, many thousands of people have used this drug for their cancer treatment and haven’t developed “flesh-eating disease”, this not really a warning to patient, but to doctors. If you have a patient that has a wound that’s not healing properly, then you need to look out for bacterial infections”, says CTV Medical Correspondent Avis Favaro.
In March, the US FDA issued a warning saying necrotizing fasciitis including fatal cases, has been reported in patients treated with Avastin; usually secondary to wound healing complications, gastrointestinal perforation or fistula formation.
If you develop any of the above or any other unusual signs or symptoms, please contact your doctor or healthcare professional immediately.
If necrotizing fasciitis occurs, AVASTIN administration should be discontinued. Your healthcare professional will decide whether AVASTIN can be re-administered.
Should you have any questions or require additional information regarding the use of AVASTIN, please contact the Drug Information Department at Hoffmann-La Roche Limited at 1-888-762-4388 from 8:30 a.m. to 4:30 p.m. Monday to Friday Eastern Standard Time.
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