Evidence map›Paper›PMID 38009115›Full record

ArticleNeuro-oncology practice2023

Plasma exchange as a tool for removal of bevacizumab: Highlighting application for urgent surgery.

Bryan J Neth, Jeffrey L Winters, Revathi Thirumushi Sairaj, Ali Gharibi Loron, Masum Rahman, Renee Hirte, Cecile Riviere-Cazaux, Michael W Ruff, Terry C Burns

Open access · greenAbstract readCase Reports
In one paragraph

Article in Neuro-oncology practice, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.6field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 1 country.

Bryan J NethDepartment of Neurology, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0003-2342-0000
Jeffrey L WintersTransfusion Medicine, Mayo Clinic, Rochester, Minnesota, USA.
Revathi Thirumushi SairajNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Ali Gharibi LoronNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Masum RahmanNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Renee HirteNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Cecile Riviere-CazauxNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.ORCID https://orcid.org/0000-0002-8857-4345
Michael W RuffDepartment of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Terry C BurnsNeurosurgery, Mayo Clinic, Rochester, Minnesota, USA.
Mayo Clinic · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Bevacizumab is commonly used to manage cerebral edema associated with brain tumors. However, its long half-life poses challenges for patients requiring urgent surgery due to wound complications. We present a case of utilizing therapeutic plasma exchange (TPE) to remove bevacizumab in a patient with recurrent glioblastoma requiring urgent surgery. Methods: A 58-year-old male with recurrent glioblastoma, IDH-wildtype, presented with clinical and radiographic concern for ventriculitis requiring urgent wound washout only 4 days after his last bevacizumab infusion. TPE was performed for 3 sessions after surgery using a centrifugation-based cell separator. Replacement fluids included normal serum albumin, normal saline, and fresh frozen plasma. Bevacizumab levels were quantified using an enzyme-linked immunoabsorbent assay before and after each TPE session. Results: TPE effectively removed bevacizumab, enabling safe surgery without new complications. Plasma bevacizumab levels decreased from 1087.63 to 145.35 ng/mL (13.4% of original) by the end of the last TPE session. This decline is consistent with nearly 3 half-lives, which compares favorably to the expected timeline of natural decline given the 21-day half-life. Conclusions: We report a complex clinical scenario of a patient requiring urgent wound washout 4 days after last bevacizumab infusion for CNS infection. Surgery was successfully performed without new complications with use of TPE to remove bevacizumab immediately following surgery. This case highlights the feasibility of this approach, which may be utilized effectively in patients requiring surgery after having recently received bevacizumab.

Indexed as

bevacizumabneuro-oncologyplasma exchangesurgerywound healing

Identifiers

PMID38009115
PMCPMC10666800
OpenAlexW4386268651

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.