Arteriovenous thrombotic events in a patient with advanced lung cancer following bevacizumab plus chemotherapy: A case report

BACKGROUND In driver gene-negative non-small cell lung cancer patients who relapse following radical resection,combination chemotherapy using bevacizumab and platinumbased dual drugs is known to increase both progression-free and overall survival.Treatment initially includes bevacizumab,and if patients are able to tolerate it,bevacizumab can continue to be utilized until disease progression.Bevacizumab is a recombinant humanized monoclonal neutralizing antibody that acts against vascular endothelial growth factor(VEGF).Various anti-VEGF monoclonal antibodies,such as bevacizumab,can increase the risk of arterial thromboembolism.Current data indicate that VEGF-targeted treatment does not significantly increase the risk of venous thromboembolism events,except for bevacizumab.CASE SUMMARY A 55-year-old man underwent radical resection for cancer of the right lung.Six months following surgery,multiple metastases were observed in his left lung.Subsequently,six cycles of bevacizumab combined with pemetrexed/carboplatin chemotherapy was given.Efficacy evaluation continued to be partial relief according to RECIST 1.1 standards,and no noticeable adverse reactions were noted.After three cycles of maintenance therapy using a combination of bevacizumab and pemetrexed,the patient developed dizziness and dyspnea.The patient was diagnosed with acute cerebral infarction and pulmonary embolism following head magnetic resonance imaging,computed tomography(CT)angiography,and chest enhanced CT.Although the patient received lowmolecular-weight heparin anticoagulation and other treatment,the patient eventually died of respiratory failure 1 mo later.This case report may offer some insight into fatal arteriovenous embolism,which has not been previously reported.CONCLUSIONBevacizumab combined with chemotherapy may also increase the risk of arteriovenousthromboembolism. Accordingly, patients who receive angiogenesis inhibitor therapy should becarefully selected. Furthermore, close monitoring and timely intervention are necessary in order toreduce the risk of such toxicities.

Aggregation Turns BODIPY Fluorophores into Photosensitizers:Reversibly Switching Intersystem Crossing On and Off for Smart Photodynamic Therapy

We report for the first time a practical and simple supramolecular approach to turn fluorophores into photosensitizers(PSs).Using boron dipyrromethene(BODIPY)as a proof-of-concept,eight BODIPY derivatives manifest bright fluorescence and generate negligible singlet oxygen in solution.In contrast,aggregation fails to emit fluorescence and enhances singlet oxygen generation.Experimentally,these aggregates have excellent photodynamic therapy(PDT)performance,and one even exhibits much stronger photocytotoxicity than the commercialized PS Ce6 under identical conditions.Theoretical studies show that this property originated from significantly reduced energy gaps between relevant excited singlet and triplet states,leading to considerably improved intersystem-crossing efficiency.Importantly,a simple disaggregation recovers the original properties of the fluorophores.This reversible switching property between fluorophores and PSs assists the development of smart PDT systems,in which singlet oxygen generation in tumors can be controlled in an intelligent manner after PDT treatment.The present work provides a novel strategy to design heavy-atom-free PSs and may pave the way to the development of smart PDT systems.