An unusual infection with long-term bevacizumab treatment for advanced nonsmall-cell lung cancer: Actinomycosis

Bevacizumab is an angiogenesis inhibitor with Food and Drug Administration approval for multiple tumor types (including colon, nonsquamous nonsmall-cell lung cancer, kidney and glioblastoma multiforme, cervix, and ovarian cancer). Here, we present a patient with actinomycosis who was on treatment with bevacizumab maintenance therapy following chemotherapy combined with bevacizumab. A 60-year-old male patient with lung adenocarcinoma was treated four cycles of carboplatin, paclitaxel with bevacizumab. And then, bevacizumab maintenance therapy was continued. After 38 months of bevacizumab maintenance, computed tomography showed a newly developed cavitary lesion in the upper lobe of the right lung. Bronchoscopy was performed and the pathology report of the biopsy was reported as actinomycosis. Bevacizumab treatment was discontinued and the patient was treated with amoxicillin-clavulanate. To our knowledge, our case is the first case of actinomycosis infection due to the possible bevacizumab treatment.