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Use of bevacizumab as a single agent or in adjunct with traditional chemotherapy regimens in children with unresectable or progressive low‐grade glioma
- Source :
- Cancer Medicine
- Publication Year :
- 2018
- Publisher :
- John Wiley and Sons Inc., 2018.
-
Abstract
- In pediatric low‐grade gliomas not amenable to complete resection, various chemotherapy regimens are the mainstream of treatment. An excellent overall survival of these patients makes justification of the intensification of chemotherapy difficult and calls for the development of new strategies. Bevacizumab, a humanized monoclonal antibody directed against Vascular endothelial growth factor (VEGF), has been successfully used in combination with irinotecan in a number of adult and pediatric studies and reports. Fifteen patients at median age of 7 years old (range 3 months to 15 years) were treated with bevacizumab in combination with conventional low‐toxicity chemotherapy. The majority had chiasmatic/hypothalamic and midline tumors, seven had confirmed BRAF pathway alterations including neurofibromatosis type 1 (2). Fourteen patients had more than one progression and three had radiotherapy. No deaths were documented, PFS at 11 and 15 months was 71.5% ± 13.9% and 44.7% ± 17.6% respectively. At the end of follow‐up 40% of patients has radiologically stable disease, three patients progressed shortly after completion of bevacizumab and two showed mixed response with progression of cystic component. Rapid visual improvement was seen in 6/8 patients, resolution of endocrine symptoms in 2/4 and motor function improvement in 4/6. No relation between histology or BRAF status and treatment response was observed. Treatment‐limiting toxicities included grade 4 proteinuria (2) and hypertension (2) managed with cessation (1) and pausing of therapy plus antihypertensives (1). In conclusion, bevacizumab is well tolerated and appears most effective for rapid tumor control to preserve vision and improve morbidity.
- Subjects :
- 0301 basic medicine
Oncology
Male
Cancer Research
medicine.medical_specialty
Bevacizumab
Adolescent
medicine.medical_treatment
Brain tumor
Antineoplastic Agents
bevacizumab
03 medical and health sciences
chemistry.chemical_compound
0302 clinical medicine
Internal medicine
Glioma
Antineoplastic Combined Chemotherapy Protocols
medicine
pediatric low‐grade glioma
cancer
Humans
Radiology, Nuclear Medicine and imaging
Child
Original Research
Chemotherapy
Proteinuria
vascular endothelial growth factor
business.industry
Brain Neoplasms
Clinical Cancer Research
Infant
medicine.disease
Magnetic Resonance Imaging
Irinotecan
Vascular endothelial growth factor
Radiation therapy
030104 developmental biology
chemistry
030220 oncology & carcinogenesis
Child, Preschool
humanized monoclonal antibody
Female
medicine.symptom
business
brain tumor
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 20457634
- Volume :
- 8
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Cancer Medicine
- Accession number :
- edsair.doi.dedup.....06f78148afc8e2301f5e1a097865d8af