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Treatment
> Bevacizumab
/ Irinotecan
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Journal of Clinical Oncology, 2006
ASCO Annual Meeting Proceedings (Post-Meeting Edition).
Vol 24, No 18S (June 20 Supplement), 2006: 1506
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Meeting Abstract |
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Bevacizumab, a monoclonal antibody to
vascular endothelial growth factor (VEGF), and irinotecan for
treatment of malignant gliomas
J. J. Vredenburgh,
A. Desjardins, J. E. Herndon, II, J.
Quinn, J. Rich, S. Sathornsumetee, H.
S. Friedman, D. Reardon, S. Gururangan
and A. Friedman
Duke University Medical Center,
Durham, NC
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Background.
The prognosis for recurrent malignant gliomas is poor, with
a median survival <12 months, median progression-free survival
<12 weeks and response rates <20%.
Malignant gliomas have
high concentrations of VEGF receptors, and the higher the
VEGF receptor concentration, the worse the prognosis.
Bevacizumab is a humanized IgG1
monoclonal antiblody to VEGF, which is synergistic with
chemotherapy for most malignancies.
Irinotecan is a topoisomerase 1
inhibitor, and has modest activity against recurrent
malignant gliomas.
Methods. We report a FDA
approved phase II trial of bevacizumab and irinotecan for the
treatment of recurrent malignant gliomas.
32 patients were enrolled, 23
with grade IV tumors (glioblastoma multiforme) and 9 with grade
III tumors (anaplastic astrocytomas or oligodendrogliomas).
All the patients had progressive
disease and every patient had received prior radiation
therapy and chemotherapy.
Patients were treated
every other week with bevacizumab 10 mg/kg and irinotecan
125 mg/m2 for patients not taking enzyme inducing anti-epileptic
drugs or 340 mg/m2 for patients taking enzyme inducing
anti-epileptic drugs.
Results. The regimen was
well tolerated with no CNS hemorrhages or >grade 1
systemic hemorrhages.
Four patients were taken off study
for thrombotic complications, 2 pulmonary emboli, 1 deep
venous thrombus, and one thrombotic stroke.
Two patients were discontinued
secondary to grade 2 proteinuria and three were
discontinued because they required non-neurosurgical
surgery, appendectomy, repair of anal fissures and hip
stabilization.
The response rate was 63% (19 PRs
and 1 CR).
The median progression-free
survival is 24 weeks.
The median overall
survival has not been reached, and exceeds 6 months.
There have been ten deaths due to
disease progression.
Conclusions. The
combination of bevacizumab and irinotecan is safe and one
of the most active regimens against malignant gliomas.
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© 2006 American Society of Clinical
Oncology
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Meeting
Abstract |
News
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