An Observational Study of the First Experience with Bevacizumab for the Treatment of Patients with Recurrent High-Grade Glioma in Two Belgian University Hospitals

Huylebrouck, Mike; Lv, Shasha; Duerinck, Johnny; Binst, A. Van; Salmon, Isabelle; Grève, Jacques De; Witte, Olivier De; Luce, Sylvie; Michotte, Alex; D’Haens, Jean; Neyns, Bart

doi:10.1155/2012/801306

Cited by 6 publications

(2 citation statements)

References 36 publications

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“…In adult HGG, the use of bevacizumab (BVZ), an anti-angiogenic agent that blocks vascular endothelial growth factor (VEGF), has shown promising results and a survival benefit in patients with recurrent HGG ( Narayana et al, 2009 ; Huylebrouck et al, 2012 ; Morris, 2012 ). These findings led to the development of a pediatric trial within the PBTC-022 utilizing BVZ and CPT-11 in children with recurrent CNS tumors, including a HGG and diffuse intrinsic pontine glioma (DIPG) strata ( Gururangan et al, 2010 ).…”

Section: Treatment Strategies and Outcomesmentioning

confidence: 99%

Pediatric High Grade Glioma: a Review and Update on Tumor Clinical Characteristics and Biology

Fangusaro¹

2012

Front. Oncol.

142

120

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High grade gliomas (HGG) are one of the most common central nervous system (CNS) tumors encountered in adults, but they only represent approximately 8–12% of all pediatric CNS tumors. Historically, pediatric HGG were thought to be similar to adult HGG since they appear histologically identical; however, molecular, genetic, and biologic data reveal that they are distinct. Similar to adults, pediatric HGG are very aggressive and malignant lesions with few patients achieving long-term survival despite a variety of therapies. Initial treatment strategies typically consist of a gross total resection (GTR) when feasible followed by focal radiotherapy combined with chemotherapy. Over the last few decades, a wealth of data has emerged from basic science and pre-clinical animal models helping to better define the common biologic, genetic, and molecular make-up of these tumors. These data have not only provided a better understanding of tumor biology, but they have also provided new areas of research targeting molecular and genetic pathways with the potential for novel treatment strategies and improved patient outcomes. Here we provide a review of pediatric non-brainstem HGG, including epidemiology, presentation, histology, imaging characteristics, treatments, survival outcomes, and an overview of both basic and translational research. An understanding of all relevant pre-clinical tumor models, including their strengths and pitfalls is essential in realizing improved patient outcomes in this population.

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Section: Treatment Strategies and Outcomesmentioning

confidence: 99%

Pediatric High Grade Glioma: a Review and Update on Tumor Clinical Characteristics and Biology

Fangusaro¹

2012

Front. Oncol.

142

120

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“…Bevacizumab associated with temozolomide showed poor efficacy compared with temozolomide alone in patients with first recurrence of grades II–III glioma without 1p19q codeletion ( 18 ). Retrospective studies suggest that bevacizumab-based combination treatments or bevacizumab alone may be a strategy for alkylating agent-refractory grade III glioma, defined as progressive disease after temozolomide ( 19 – 22 ). Few prospective studies (phase II) showed a potential interest of bevacizumab as rescue treatment for recurrent grade III glioma ( 23 , 24 ).…”

Section: Introductionmentioning

confidence: 99%

Bevacizumab in recurrent WHO grades II–III glioma

et al. 2023

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PurposeThe management of recurrent WHO grades II–III (rGII–III) glioma is not well established. This study describes the clinical outcomes in patients who received bevacizumab as rescue treatment.MethodsIn this retrospective study, the main inclusion criteria were as follows: adult patients with histologicaly proved rGII–III glioma according 2016 WHO classification treated with bevacizumab from 2011 to 2019, T1 contrast enhancement on MRI. Efficacy was assessed using the high-grade glioma 2017 Response Assessment in Neuro-Oncology criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan–Meier method.ResultsEighty-one patients were included (M/F ratio: 1.7, median age at diagnosis: 38 years) among whom 46 (56.8%) had an initial diagnosis of grade II glioma. Previous treatments included at least one surgical intervention, radiotherapy (98.8%), and ≥ 2 chemotherapy lines (64.2%). After bevacizumab initiation, partial response, stable disease, and progressive disease were observed in 27.2%, 22.2%, and 50.6% of patients. The median PFS and OS were 4.9 months (95% confidence interval [CI] 3.7–6.1) and 7.6 months (95% CI 5.5–9.9). Bevacizumab severe toxicity occurred in 12.3%. Twenty-four (29.6%) patients discontinued bevacizumab without radiological progression. Oligodendroglioma and age ≥ 38 years at diagnosis were more frequent in this subgroup (odds ratio = 0.24, 95% CI 0.07–0.84, p = 0.023 and 0.36, 95% CI 0.13–0.99, p = 0.042). Ten of these 24 patients were alive at 12 months and two patients at 8 years after bevacizumab initiation, without any subsequent treatment.ConclusionBevacizumab can be an option for heavily pretreated patients with rGII–III glioma with contrast enhancement. In our study, bevacizumab displayed prolonged activity in a subgroup of patients.

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Patient outcome in the Belgian medical need program on bevacizumab for recurrent glioblastoma

et al. 2015

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Bevacizumab (BEV) has demonstrated anti-tumor activity in patients with recurrent glioblastoma (rGB). Given the unmet need for active therapeutic options in rGB patients, a medical need program was initiated by the Belgian competent authorities. Between November 2010 and February 2013, a total of 313 patients with rGB initiated treatment with BEV administered at a dose of 10 mg/kg every 2 weeks. All patients had failed prior treatment with at least radiation therapy and temozolomide and the majority of patients (70 %) were treated with corticosteroids at baseline. Patients received a median of 6 BEV administrations (range 1-53). Overall, BEV was well tolerated. During BEV treatment the WHO-Performance Score (WHO-PS) improved in 59 patients (19 %) and stabilized for at least 6 weeks in an additional 139 (44 %) patients. Corticosteroid treatment could be stopped in 16 % or reduced in dose in 32 % of patients. The best objective tumor response rate using RANO criteria (investigator's assessment) was 3.5 % CR, 22 % PR, 38 % SD and 37 % PD. The median and 6-month PFS were 13 weeks (95 % CI 12.7-14) and 27.3 % (95 % CI 22.3-32.5), median and 6-month OS rates were 26 weeks (23-29) and 52 % (46.4-58.6), respectively. WHO-PS (0-1 vs. 2-3) and baseline steroid use were significantly correlated with PFS and OS. Our observations support the use of BEV as a monotherapy for patients with rGB who have no alternative treatment options. Optimal benefit from BEV treatment is likely to be obtained when treatment is initiated before the performance status deteriorates to two or less.

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An Observational Study of the First Experience with Bevacizumab for the Treatment of Patients with Recurrent High-Grade Glioma in Two Belgian University Hospitals

Cited by 6 publications

References 36 publications

Pediatric High Grade Glioma: a Review and Update on Tumor Clinical Characteristics and Biology

Pediatric High Grade Glioma: a Review and Update on Tumor Clinical Characteristics and Biology

Bevacizumab in recurrent WHO grades II–III glioma

Patient outcome in the Belgian medical need program on bevacizumab for recurrent glioblastoma

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