Healing and targeted therapies: Management in perioperative period?

• Published in: Progrès en urologie (Paris) Vol. 21; no. 3; p. 166
• Main Authors: Pignot, G, Lebret, T, Chekulaev, D, Peyromaure, M, Saighi, D, Flam, T, Amsellem-Ouazana, D, Debre, B, Zerbib, M
• Format: Journal Article
• Language: French
• Published: France 01.03.2011
• Subjects: Angiogenesis Inhibitors - adverse effects; Humans; Kidney Neoplasms - drug therapy; Neovascularization, Physiologic; Perioperative Period; Wound Healing - drug effects; Wound Healing - physiology
• ISSN: 1166-7087
• DOI: 10.1016/j.purol.2010.09.023

In the era of new-targeted therapies and neoadjuvant strategies, this article highlights the role of angiogenesis in the process of physiological wound healing with a review of literature about parietal complications under anti-angiogenic therapies. Research on Medline was carried out using the terms renal cell carcinoma, angiogenesis, wound healing, targeted therapies, and complications. The frequency of these complications varies between 5 and 50% in recent series. These results depend on half-lives of each drug and perioperative management (before and after surgical procedure). In the absence of current recommendations, it is advised to stop bevacizumab at least five weeks before a surgical intervention and to take it back 4 weeks later. For the tyrosine kinase inhibitors, the treatment can be stopped 24-48 hours before the surgery and taken back 3-4 weeks later. Finally, for the mTOR inhibitors, it is advised to stop the treatment 7-10 days before and to take back it at least 3 weeks later.