Single‐agent bevacizumab in the treatment of recurrent or refractory pediatric low‐grade glioma: A single institutional experience

Gorsi, Hamza; Khanna, Paritosh C.; Tumblin, Mark; Yeh-Nayre, Lanipua; Milburn, Mehrzad; Elster, Jennifer; Crawford, John R.

doi:10.1002/pbc.27234

Cited by 34 publications

(39 citation statements)

References 9 publications

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“…This study showed a median survival of 9 months (17). In a recent study with the biggest number of cases in the literature, bevacizumab used as a single agent in the treatment of recurrent and refractory pediatric low grade glioma and showed 80% objective response rate (12 of 15 patients showed radiologic response) (18). In our case, a good treatment response with bevacizumab was seen in a SCA.…”

Section: Discussionsupporting

confidence: 56%

Bevasizumab’a İyi Cevap Veren, Radyoterapi ve Temozolomid Tedavisine Yanıtsız Bir Erişkin Spinal Kord Astrositomu; Olgu Sunumu ve Literatür Derlemesi

Kefeli

Halil

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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The incidence of spinal cord astrocytomas (SCAs) is very low and therefore, management of these tumors are challenging due to this paucity. In this report, a patient with a recurrent SCA was successfully treated with bevacizumab after failing to previous therapies including radiotherapy (RT) and temozolomide (TMZ). Bevacizumab is an angiogenesis inhibitor that is widely used in high grade gliomas and shows promise for SCAs but there is limited data about the usage of bevacizumab in SCAs. We herein add an important contribution to the literature by reporting a nearly total response to bevacizumab in a patient with low grade SCA.

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Section: Discussionsupporting

confidence: 56%

Bevasizumab’a İyi Cevap Veren, Radyoterapi ve Temozolomid Tedavisine Yanıtsız Bir Erişkin Spinal Kord Astrositomu; Olgu Sunumu ve Literatür Derlemesi

Kefeli

Halil

2021

Kahramanmaraş Sütçü İmam Üniversitesi Tıp Fakültesi Dergisi

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“…No research has been done on the use of bevacizumab in ACP patients, but one small case series reviewed the use of bevacizumab in three patients with pilocytic astrocytoma (PA), another predominantly cystic tumor, and found that all three patients tolerated the therapy well and resulted in a decrease cyst volumes (22). Bevacizumab has also been shown recently to have clinical and radiographic effects in adult PA patients (23, 24) and has been shown to be a safe and tolerated therapy in pediatric patients with PA and other forms of low-grade glioma (25, 26). Overall, the patients presented tolerated therapy well without significant side effects or complications other than isolated Grade 3 neutropenia without associated infections.…”

Section: Discussionmentioning

confidence: 99%

Targeting IL-6 Is a Potential Treatment for Primary Cystic Craniopharyngioma

et al. 2019

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Adamantinomatous craniopharyngioma (ACP) makes up between 6 and 8% of pediatric brain tumors and is the most common pediatric tumor arising in the sellar/suprasellar region of the brain. The 10-year survival for patients diagnosed with craniopharyngioma ranges between 64 and 92%, but complicating factors such as location, common cyst formation, and potential hypothalamic infiltration cause significant morbidity in this population. There are a number of therapeutic options for children with ACP, including surgery, radiation, and cyst directed therapies such as interferon and bleomycin. Research has raised concerns regarding the efficacy and side effects associated with these conventional therapies, as well as with the difficulty in treating recurrent cystic ACP. Evidence from our group and others has shown that the cystic and solid tumor components of craniopharyngioma have high levels of IL-6R and IL-6, providing a potential target for therapy. Tocilizumab, a humanized monoclonal antibody, acts against soluble and membrane bound IL-6R, and has been widely utilized in pediatric patients. Two patients with recurrent cystic ACP were offered systemically administered tocilizumab or a combination of tocilizumab and bevacizumab on a compassionate use basis. Both patients' tumors had a significant response, with decreased cyst burden, supporting the assertion that tocilizumab with or without bevacizumab may be an option for patients suffering from cystic ACP.

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“…9,10 Bevacizumab alone has also shown some efficacy in treatment of LGG. 11 Published trials of kinase inhibitors in pediatric LGG to date include investigations of sorafenib (a multikinase inhibitor), everolimus (an mTOR inhibitor), and selumetinib (a MEK inhibitor). [12][13][14] The phase II study of multikinase inhibitor sorafenib in patients with recurrent or progressive…”

mentioning

confidence: 99%

Trametinib-based Treatment of Pediatric CNS Tumors: A Single Institutional Experience

Paul

Pehlivan²,

Milburn

et al. 2020

Journal of Pediatric Hematology/Oncology

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MEK inhibitors are an emerging therapy with increasing use in mitogen-activated protein kinase-driven central nervous system (CNS) tumors. There is limited data regarding efficacy and toxicity in pediatric patients. We report our clinical experience with trametinib-based therapy for the treatment of 14 consecutive pediatric patients with recurrent low-grade glioma (N = 11) or highgrade CNS tumors (N = 3) with MAP kinase pathway mutations. Patients received trametinib as monotherapy (N = 9) or in combination (N = 5) with another antineoplastic agent. Nine patients (64%) were progression free during treatment. Five patients showed a partial response, while 4 had stable disease. Two patients (14%) progressed on therapy. All partial responses were in patients with low-grade tumors. The remaining 3 patients were not evaluable due to toxicity limiting duration of therapy. Two of 3 patients with lowgrade glioma with leptomeningeal dissemination showed radiographic treatment response. Five patients reported improved clinical symptoms while on trametinib. Adverse events on trametinib-based therapy included dermatologic, mouth sores, fever, gastrointestinal, infection, neutropenia, headache, and fatigue, and were more common in patients using combination therapy. Trametinib-based therapy demonstrated signals of efficacy in our single institutional cohort of pediatric patients with mitogen-activated protein kinasedriven CNS tumors. Our observations need to be confirmed in a clinical trial setting.

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Single‐agent bevacizumab in the treatment of recurrent or refractory pediatric low‐grade glioma: A single institutional experience

Abstract: Single-agent bevacizumab is efficacious in the management of recurrent or refractory pediatric LGG with radiographic and clinical responses similar to those reported for bevacizumab-based therapies.

Cited by 34 publications

References 9 publications

Bevasizumab’a İyi Cevap Veren, Radyoterapi ve Temozolomid Tedavisine Yanıtsız Bir Erişkin Spinal Kord Astrositomu; Olgu Sunumu ve Literatür Derlemesi

Bevasizumab’a İyi Cevap Veren, Radyoterapi ve Temozolomid Tedavisine Yanıtsız Bir Erişkin Spinal Kord Astrositomu; Olgu Sunumu ve Literatür Derlemesi

Targeting IL-6 Is a Potential Treatment for Primary Cystic Craniopharyngioma

Trametinib-based Treatment of Pediatric CNS Tumors: A Single Institutional Experience

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