Lack of anti-tumor activity by anti-VEGF treatments in hepatic hemangiomas

Recently, anti-vascular endothelial growth factor (anti-VEGF) agents have been described in the literature as a valid treatment option for symptomatic liver hemangiomas, but only limited evidence supports this notion. The purpose of this study was to elucidate whether or not the administration of anti-VEGF agents can reliably achieve a size reduction in liver hemangiomas. We examined patients with incidental hemangiomas who received anti-angiogenic agents for the treatment of other malignancies. Our study population consisted of 17 colorectal cancer patients and one lung cancer patient carrying 21 hemangiomas who received bevacizumab, and seven renal cell carcinoma patients carrying nine hepatic hemangiomas who received sunitinib. We have measured the liver hemangioma volume on both the pre-treatment and post-treatment computed tomography images and then calculated the volume alteration rates. No statistically significant difference (P = 0.365) in the volume of the liver hemangiomas was observed before (1.1–168.8 cm³; mean ± SD 19.8 ± 39.7 cm³) or after (1.2–163.6 cm³; 19.3 ± 38.0 cm³) bevacizumab treatment. The volume reduction rate ranged from −35.0 to 11.2 % (mean ± SD −1.3 ± 10.8 %). The sunitinib treatment group also showed no statistically significant difference (P = 0.889) in hemangioma volume before (1.2–6.5 cm³; 3.0 ± 1.8 cm³) or after (1.2–6.0 cm³; 3.0–1.7 cm³) treatment. The volume reduction rate ranged from −13.3 to 7.7 % (median: mean ± SD −2.5 ± 6.6 %). We did not observe liver hemangioma shrinkage after bevacizumab or sunitinib treatment. Our data do not support the application of anti-VEGF agents for the treatment of hepatic hemangiomas.