The Effect of Bevacizumab on Vestibular Schwannoma Related to Neurofibromatosis Type 2

Abstract

Introduction:We describe an Australian experience of infusional bevacizumab for vestibular schwannoma (VS) in neurofibromatosis type 2 patients, with specific focus on 3-dimensional tumour volume and audiometry.Method: Data was pooled from patients with symptomatic or progressive VS from 2009 to April 2018. Tumours were assessed as total volume per patient. Bevacizumab infusions were administered every 2-4 weeks. 3-D volumetric response (cm 3 ) was determined through serial magnetic resonance imaging, at baseline and at 3-6-month intervals, until cessation of infusions following progression or prior to surgery. Volumetric response was defined as a reduction of volume ³ 20%, from baseline. Patients underwent interval pure tone audiometry. A decrease in the average pure tone analyses by 10dB indicated response.Results: Twenty-one VS tumours were identified in eleven patients. Median age was 26 (range 13 -67yr). Average baseline tumour volume was 14.17cm 3 (range 1.45cm 3 -38.51cm 3 ). Tumour volume reduction >20% was shown in 7/11 patients (64%), indicating partial response, 2/11 (18%) patients showed stable disease, and 2/11 (18%) progressed. Average percentage tumour volume change was +4.45% from baseline (range -57% to 241%). 16 individual ears were tested, 3/16 (19%) of ears showed an average decibel reduction of 10dB or more, indicating response (average change 2.5dB, range -36dB to 81dB). 10/16 (63%) showed stable hearing, and 3/16 (19%) showed hearing deterioration. Conclusion:Bevacizumab is a useful agent for reducing tumour volume and improving hearing losses due to vestibular schwannoma in neurofibromatosis type 2 patients. These results reflect results described from the United Kingdom and United States.

Involvement of Resveratrol against Brain Cancer: A Combination Strategy with a Pharmaceutical Approach

“…If the tumor cannot be controlled or cured, then the disease may be called terminal or advanced. When diagnosed with advanced BT, the expected life span is calculated to be less than 6 months [ 13 ].…”