Literature DB >> 22287258

Bevacizumab and irinotecan in children with recurrent or refractory brain tumors: toxicity and efficacy trends.

Marie-Laure Couec1, Nicolas André, Estelle Thebaud, Odile Minckes, Xavier Rialland, Nadège Corradini, Isabelle Aerts, Perrine Marec Bérard, Franck Bourdeaut, Pierre Leblond.   

Abstract

BACKGROUND: Bevacizumab, a monoclonal antibody targeting the vascular endothelial growth factor, has proven efficacy in some adult tumors; it is now proposed as a new therapeutic strategy for refractory or recurrent brain tumors in some children, either alone or combinated. PROCEDURE: We retrospectively analyzed 28 children who received bevacizumab on a compassionate basis for refractory or recurrent brain tumors between June 2007 and August 2010 in 7 French centers. Among them, 12 had high-grade gliomas, 7 low-grade gliomas, 4 ependymomas, 2 primitive neurectodermal tumors, 3 neuroglial tumors. The median age at start of bevacizumab was 11.0 years. Bevacizumab was administered at 5-10 mg/kg every 2 weeks, with concomitant chemotherapy for 27 patients.
RESULTS: Bevacizumab was used in combination with irinotecan in 27 patients. Bevacizumab-related toxicity was mild. Toxicities reported were grade I-II hypertension (n = 4), proteinuria (n = 1), lymphopenia (n = 2), wound healing delay (n = 2). Whereas tumor reduction could be observed in 6:7 patients with low-grade gliomas, no efficacy could be documented in patients with high-grade glioma, nor PNET nor ependymoma.
CONCLUSION: Bevacizumab-related acute toxicity appears to be low in children, even in combination with irinotecan. Further prospective trials are required to confirm the hypothetical efficacy of bevacizumab and to assess the risk of long-term toxicity especially in the youngest children.
Copyright © 2012 Wiley Periodicals, Inc.

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Year:  2012        PMID: 22287258     DOI: 10.1002/pbc.24066

Source DB:  PubMed          Journal:  Pediatr Blood Cancer        ISSN: 1545-5009            Impact factor:   3.167


  24 in total

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3.  Decreased tumor apparent diffusion coefficient correlates with objective response of pediatric low-grade glioma to bevacizumab.

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5.  Treatment of childhood astrocytomas with irinotecan and cisplatin.

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Review 7.  Pediatric low-grade gliomas: how modern biology reshapes the clinical field.

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Review 8.  Neurocognitive functioning in adult WHO grade II gliomas: impact of old and new treatment modalities.

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9.  Angiogenesis and angiogenic tyrosine kinase receptor expression in pediatric brain tumors.

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Review 10.  Vascular stenosis in a child with visual pathway glioma treated with bevacizumab: a case report and review of literature.

Authors:  Chiara Pilotto; Ismail Beshlawi; Adam Thomas; Richard G Grundy
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