A multi-institutional phase II trial of bevacizumab for recurrent and refractory meningioma.

Autor:	Kumthekar P; The Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.; Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.; Northwestern University, Chicago, IL, USA., Grimm SA; Department of Neurology, Rush University Medical Center, Chicago, IL, USA., Aleman RT; Department of Internal Medicine, Advocate Christ Medical Center, Oak Lawn, IL, USA., Chamberlain MC; University of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care Alliance, Seattle, WA, USA., Schiff D; University of Virginia School of Medicine, Charlottesville, VA, USA., Wen PY; Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard School of Medicine, Boston, MA, USA., Iwamoto FM; Columbia Medical Center, New York, NY, USA., Gursel DB; Northwestern University, Chicago, IL, USA.; Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA., Reardon DA; Dana-Farber Cancer Institute, Boston, MA, USA.; Harvard School of Medicine, Boston, MA, USA., Purow B; University of Virginia School of Medicine, Charlottesville, VA, USA., Kocherginski M; Department of Preventative Medicine, Feinberg College of Medicine at Northwestern University, Chicago, IL, USA., Helenowski I; Department of Preventative Medicine, Feinberg College of Medicine at Northwestern University, Chicago, IL, USA., Raizer JJ; The Lou and Jean Malnati Brain Tumor Institute, Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL, USA.; Department of Neurology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA.; Northwestern University, Chicago, IL, USA.
Jazyk:	angličtina
Zdroj:	Neuro-oncology advances [Neurooncol Adv] 2022 Aug 19; Vol. 4 (1), pp. vdac123. Date of Electronic Publication: 2022 Aug 19 (Print Publication: 2022).
DOI:	10.1093/noajnl/vdac123
Abstrakt:	Background: Systemic therapies for refractory meningiomas are limited with no FDA-approved therapeutics. Vascular endothelial growth factor (VEGF) is a signaling protein associated with neovascularization, peritumoral edema, and meningioma tumorigenesis. Methods: This phase II study investigates the efficacy of bevacizumab (BEV), a VEGF binding monoclonal antibody, in patients with progressive Grade I (G1M), Grade II (G2M), Grade III (G3M) meningioma, and other non-parenchymal tumors including vestibular schwannoma ( n  = 4) and hemangiopericytoma ( n  = 4) with the primary endpoint of progression-free survival rate at 6-months (PFS-6). Non-meningiomas were included with the respective meningioma grade in the analysis. Secondary endpoints include median overall survival (mOS) and response rate. Results: Fifty Patients (26 women; median age 54 years; range 23-81), 42 with progressive meningioma were treated: 10 G1M, 20 G2M, and 12 G3M. Prior treatments include surgical resection (41 patients), radiosurgery (24 patients), external beam radiotherapy (28 patients), and chemotherapy (14 patients). Median infusions administered were 16 (range, 2-68). Response was graded using the Macdonald's criteria. PFS-6, median PFS, and mOS were 87%, 22 months, 35 months for G1M; 77%, 23 months, 41 months for G2M; and 46%, 8 months, 12 months for G3M. Best radiographic responses include stable disease (G1M: 100%; G2M: 85%; G3M: 82%); partial response (G1M: 0%; G2M: 5%; G3M: 0%) and progressive disease (G1M: 0%; G2M: 10%; G3M:18%). The most common toxicities were hypertension ( n  = 19, 42.2%), proteinuria ( n  = 16, 35.6%), and fatigue ( n  = 14, 31.1%). Conclusion: This study showed BEV is well tolerated and appears to be a promising systemic treatment option for patients with recurrent and refractory meningiomas. (© The Author(s) 2022. Published by Oxford University Press, the Society for Neuro-Oncology and the European Association of Neuro-Oncology.)
Databáze:	MEDLINE
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