Controversies in Neuro-Oncology

Avastin and Malignant Gliomas

Indexed in: Chemical Abstracts, EBSCO, Ulrich's Periodicals Directory.

Neuro-oncology is an embryonic field of cancer research with a number of clinical trials in progress. However, the prognosis on neuro-oncologic patients has remained poor. Moreover, several small ...
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Salvage Chemotherapy with Bevacizumab for Recurrent Anaplastic Glioma

Pp. 127-132 (6)

Marc C. Chamberlain

Abstract

Background: The treatment of recurrent anaplastic glioma (AG) like all high-grade gliomas (HGG) is problematic, as only partially effective therapeutic modalities are available and there is a lack of a standard therapy for recurrence. Methods: A literature review of the use of bevacizumab for recurrent HGG including five studies involving recurrent AG. Results: In the 5 studies of bevacizumab for the treatment of recurrent AG (n=140 patients) neuroradiographic response rates were as follows; complete response 0-20%, partial response 34-68% (median 52%), and stable disease 5-59% (median 16%). Median overall survival was 28 weeks (range 18-35 weeks) and progression free survival at 6- and 12-months was 55% (range 32-68%) and 23% (16-39%) respectively. Conclusions: Bevacizumab therapy appears to increase response of recurrent AG by 2-fold and 6- month progression free survival by 1.5 fold without a clear benefit with respect to overall survival. Toxicity of bevacizumab therapy is manageable and most often comprised of hypertension, proteinuria and fatigue. To date, there are no multi-institutional prospective trials evaluating the role of bevacizumab for the treatment of recurrent AG notwithstanding the increasingly common use of bevacizumab for this indication.

Affiliation:

Department of Neurology and Neurological Surgery, Division of Neuro-Oncology, University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, 825 Eastlake Avenue E, POB 19023, MS G4940, Seattle, WA 98109-1023