Authors: Chintan Parekh Rima Jubran Anat ErdreichEpstein Ashok Panigrahy Stefan Bluml Jonathan Finlay Girish Dhall
Publish Date: 2010/11/01
Volume: 103, Issue: 3, Pages: 673-680
Abstract
Children with recurrent high grade gliomas HGG have a dismal outcome with a median progression free survival PFS of 12 weeks Adults with recurrent HGG treated with irinotecan and bevacizumab reportedly have a 63 response rate and a median PFS of 23 weeks There is a paucity of corresponding published pediatric data We retrospectively reviewed the records of patients less than 21 years of age with recurrent or progressive WHO grade 3–4 gliomas who were treated with bevacizumab containing regimens at our institution between January 2006 and September 2008 We identified eight patients Six out of eight patients received irinotecan temozolomide and bevacizumab one patient received irinotecan and bevacizumab and one patient received CCNU and bevacizumab Three patients had stable disease for 30–93 weeks The remaining five patients developed progressive disease within 17 weeks The median PFS was 15 weeks and the 6month PFS was 38 Contrast enhancing disease responded or remained stable in five out of seven patients whereas nonenhancing disease progressed in three out of four patients New distant nonenhancing lesions developed in three patients The most common side effects included diarrhea vomiting thrombocytopenia and neutropenia Bevacizumab was well tolerated when used in combination with conventional chemotherapy irinotecan in most cases PFS in our cohort was much shorter and the response rate was inferior in this small cohort of patients when compared with published adult data However bevacizumab containing regimens might be effective in a subset of pediatric patients especially those with predominantly contrastenhancing disease
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