BACKGROUND: Patients with relapsed chronic lymphocytic leukemia (CLL) often achieve response with chemoimmunotherapy but have short remission durations. Studies have shown that patients with CLL have increased angiogenesis in the microenvironment; levels of proangiogenic growth factors such as VEGF and/or angiopoietin-2 are also elevated. Increased angiogenesis correlates with poor outcome in CLL. Bevacizumab (B) is a humanized monoclonal antibody targeting VEGF-A. METHODS: In this study, we analyzed whether a combination of bevacizumab with fludarabine, cyclophosphamide, and rituximab chemoimmunotherapy (FCR-B) could improve outcomes in patients with relapsed CLL. Sixty-two patients were enrolled. The median age of the patients was 60 years (range, 31-84 years) and 40% had received >1 prior therapy for CLL. Sixty-one patients were evaluable for toxicity, and 57 were evaluable for response. Six cycles were planned; 36 patients (59%) completed ≥4-6 cycles of the regimen. RESULTS: The overall response rate was 79%, with 13 (23%) complete remissions (CRs), 8 nodular partial remissions (14%), and 24 partial remissions (43%). The median progression-free survival and overall survival rates were 13.5 and 45 months, respectively. Grade 3 or 4 toxicities included febrile neutropenia (n = 40), infections (n = 21), thrombocytopenia (n = 18) and anemia (n = 9). CONCLUSIONS: Results with FCR-B were similar to those observed with an historical cohort of relapsed patients treated with FCR.
BACKGROUND:Patients with relapsed chronic lymphocytic leukemia (CLL) often achieve response with chemoimmunotherapy but have short remission durations. Studies have shown that patients with CLL have increased angiogenesis in the microenvironment; levels of proangiogenic growth factors such as VEGF and/or angiopoietin-2 are also elevated. Increased angiogenesis correlates with poor outcome in CLL. Bevacizumab (B) is a humanized monoclonal antibody targeting VEGF-A. METHODS: In this study, we analyzed whether a combination of bevacizumab with fludarabine, cyclophosphamide, and rituximab chemoimmunotherapy (FCR-B) could improve outcomes in patients with relapsed CLL. Sixty-two patients were enrolled. The median age of the patients was 60 years (range, 31-84 years) and 40% had received >1 prior therapy for CLL. Sixty-one patients were evaluable for toxicity, and 57 were evaluable for response. Six cycles were planned; 36 patients (59%) completed ≥4-6 cycles of the regimen. RESULTS: The overall response rate was 79%, with 13 (23%) complete remissions (CRs), 8 nodular partial remissions (14%), and 24 partial remissions (43%). The median progression-free survival and overall survival rates were 13.5 and 45 months, respectively. Grade 3 or 4 toxicities included febrile neutropenia (n = 40), infections (n = 21), thrombocytopenia (n = 18) and anemia (n = 9). CONCLUSIONS: Results with FCR-B were similar to those observed with an historical cohort of relapsed patients treated with FCR.
Authors: Andrea G S Buggins; Chris Pepper; Piers E M Patten; Saman Hewamana; Satyen Gohil; Jane Moorhead; Najeem'deen Folarin; Deborah Yallop; N Shaun B Thomas; Ghulam J Mufti; Chris Fegan; Stephen Devereux Journal: Cancer Res Date: 2010-08-24 Impact factor: 12.701
Authors: Krishnansu S Tewari; Michael W Sill; Harry J Long; Richard T Penson; Helen Huang; Lois M Ramondetta; Lisa M Landrum; Ana Oaknin; Thomas J Reid; Mario M Leitao; Helen E Michael; Bradley J Monk Journal: N Engl J Med Date: 2014-02-20 Impact factor: 91.245
Authors: Michael Hallek; Bruce D Cheson; Daniel Catovsky; Federico Caligaris-Cappio; Guillaume Dighiero; Hartmut Döhner; Peter Hillmen; Michael J Keating; Emili Montserrat; Kanti R Rai; Thomas J Kipps Journal: Blood Date: 2008-01-23 Impact factor: 22.113
Authors: Herbert Hurwitz; Louis Fehrenbacher; William Novotny; Thomas Cartwright; John Hainsworth; William Heim; Jordan Berlin; Ari Baron; Susan Griffing; Eric Holmgren; Napoleone Ferrara; Gwen Fyfe; Beth Rogers; Robert Ross; Fairooz Kabbinavar Journal: N Engl J Med Date: 2004-06-03 Impact factor: 91.245
Authors: Jamison Brooks; Darren Zuro; Joo Y Song; Srideshikan Sargur Madabushi; James F Sanchez; Chandan Guha; Marcin Kortylewski; Bihong T Chen; Kalpna Gupta; Guy Storme; Jerry Froelich; Susanta K Hui Journal: Int J Radiat Oncol Biol Phys Date: 2021-11-09 Impact factor: 8.013
Authors: Neil E Kay; Paolo Strati; Betsy R LaPlant; Jose F Leis; Daniel Nikcevich; Timothy G Call; Adam M Pettinger; Connie E Lesnick; Curtis A Hanson; Tait D Shanafelt Journal: Oncotarget Date: 2016-11-29
Authors: Julie-Ann Hulin; Sara Tommasi; David Elliot; Dong Gui Hu; Benjamin C Lewis; Arduino A Mangoni Journal: Sci Rep Date: 2017-10-25 Impact factor: 4.379