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April 1, 2008

Suppression of Melanoma-Associated Neoangiogenesis by Bevacizumab

Author Affiliations

Author Affiliations: University Eye Clinic (Drs Jaissle, Henke-Fahle, Bartz-Schmidt, and Szurman) and Department of Dermatology (Drs Ulmer and Fierlbeck), Eberhard-Karls-University of Tuebingen, Tuebingen, Germany.

Arch Dermatol. 2008;144(4):525-527. doi:10.1001/archdermatol.2007.38

Background  Bevacizumab, a potent antibody against the vascular endothelial growth factor (VEGF), has been shown to be effective for treatment of colorectal cancer. Recently, high effectiveness of bevacizumab in combination with paclitaxel has been reported in a single metastatic melanoma case. To our knowledge, we demonstrate for the first time the antiangiogenetic effect of bevacizumab in a patient with a vitreous melanoma metastasis.

Observations  A 68-year-old man with a vitreous melanoma metastasis of the left eye was treated with a revitrectomy combined with intravitreal bevacizumab application because of iris neovascularization and progressive epiretinal tumor plaques. Four days after the treatment, the melanoma-associated neovascularization completely disappeared, but it recurred after 6 weeks. Although repetitive administration of local bevacizumab produced the same antiangiogenetic effect, progression of the epiretinal tumor plaques could not be stopped with the local bevacizumab treatment.

Conclusions  Intraocular administration of the anti-VEGF drug bevacizumab causes immediate and complete regression of melanoma-associated angiogenesis. The rationale for the therapeutic strategy in our patient was an elevated level of VEGF in the vitreous cavity. Because we could not demonstrate a direct antiproliferative effect of bevacizumab on melanoma metastasis, bevacizumab seems most promising if evaluated in combination with antiproliferative agents.