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Tytuł pozycji:

Use of bevacizumab as a single agent or in adjunct with traditional chemotherapy regimens in children with unresectable or progressive low‐grade glioma

Tytuł :
Use of bevacizumab as a single agent or in adjunct with traditional chemotherapy regimens in children with unresectable or progressive low‐grade glioma
Autorzy :
Zhukova, Nataliya
Rajagopal, Revathi
Lam, Adrienne
Coleman, Lee
Shipman, Peter
Walwyn, Thomas
Williams, Molly
Sullivan, Michael
Campbell, Martin
Bhatia, Kanika
Gottardo, Nicholas G.
Hansford, Jordan R.
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Temat :
Original Research
Clinical Cancer Research
bevacizumab
brain tumor
cancer
humanized monoclonal antibody
pediatric low‐grade glioma
vascular endothelial growth factor
Źródło :
Cancer Medicine. 8
Wydawca :
John Wiley and Sons Inc., 2018.
Rok publikacji :
2018
Oryginalny identyfikator :
pmc: PMC6346232
pmid: 30569607
Język :
English
ISSN :
2045-7634
DOI :
10.1002/cam4.1799
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.
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