Patterns of progression in pediatric patients with high-grade glioma or diffuse intrinsic pontine glioma treated with Bevacizumab-based therapy at diagnosis.

Abstract

There is a paucity of data regarding patterns of progression in children with high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG) treated with bevacizumab (BVZ) at diagnosis. We performed a retrospective study of 20 children with HGG or DIPG who received BVZ-based therapy at diagnosis on, or according to, a bi-institutional study. Magnetic resonance imaging (MRI) characteristics of first and most recent progressions were reviewed. Comparison was made to a control group of 19 patients who never received BVZ. Imaging definitions of progressive disease (PD) were local: at primary site or within 2 cm, contiguous; diffuse: >2 cm away but contiguous with primary site, ill-defined and infiltrative; distant: new, non-contiguous disease. In the BVZ-treated group, 14 patients had DIPG, six patients had HGG. Median age was 7 years (range: 3-21). Median time to PD and follow-up were 8.8 months (range 4-21) and 11 months (range: 6-25), respectively. Among 14 patients with PD, 8 (57.1 %) had local PD, 6 (42.9 %) had local and diffuse/distant PD, at initial progression. At most recent progression, a median of 10.8 months (range 6-25) from diagnosis, 10 of 14 (71.4 %) had at least diffuse (n = 8), or distant (n = 6) PD. In the comparable control group, 15 patients had PD: 11(73.3 %) local, 4 (26.7 %) local and diffuse/distant PD at first and most recent progressions. Based on these data, we postulate that BVZ may lead to a higher incidence of distant and diffuse disease in newly-diagnosed children with HGG or DIPG who received BVZ-based therapy.

• Authors: Ralph Salloum, Mariko DeWire, Adam Lane, Stewart Goldman, Trent Hummel, Lionel Chow, Lili Miles, Mary Sutton, Charles Stevenson, Maryam Fouladi, James Leach
• Journal: Journal of neuro-oncology (J Neurooncol) Vol. 121 Issue 3 Pg. 591-8 (Feb 2015) ISSN: 1573-7373 [Electronic] United States
• PMID: 25433556 (Publication Type: Journal Article)

Chemical References

• Antibodies, Monoclonal, Humanized
• Antineoplastic Agents
• Bevacizumab
• Irinotecan
• Camptothecin

Topics

• Adolescent
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Agents (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (administration & dosage)
• Bevacizumab
• Brain Neoplasms (drug therapy, pathology)
• Camptothecin (administration & dosage, analogs & derivatives)
• Chemoradiotherapy
• Child
• Child, Preschool
• Disease Progression
• Female
• Glioma (drug therapy, pathology)
• Humans
• Irinotecan
• Male
• Neoplasm Grading
• Retrospective Studies
• Young Adult