Researchers from the Memorial Sloan-Kettering Cancer Center have reported that Avastin® (bevacizumab) and hypofractionated stereotactic radiotherapy is safe and effective for treatment of recurrent malignant gliomas. The details of this study appeared in the September 1, 2009 issue of the International Journal of Radiation Oncology, Biology & Physics.[1]
Avastin is a humanized monoclonal antibody that is targeted against the vascular endothelial growth factor (VEGF). The U.S. Food and Drug Administration (FDA) has approved Avastin as a single agent for the treatment of glioblastoma that has progressed following prior therapy. A previous study from Duke University showed a 57% response rate for 23 patients with recurrent glioblastoma multiforme following treatment with Avastin and Camptosar® (irinotecan).2 The main side effects were thromboembolic, and the regimen was described as well tolerated. Researchers from Israel have also reported that the combination of Avastin and Camptosar is an effective combination for the treatment of recurrent high-grade gliomas. However, researchers from the University of California at Los Angeles have reported that patients with recurrent glioblastoma who were treated with Avastin alone experienced a slight survival advantage compared with patients treated with Avastin plus Camptosar. The effects of administering Avastin with radiotherapy have not been extensively evaluated.
The current study included 25 patients with recurrent glioblastoma or anaplastic gliomas who had failed standard radiation therapy. All received concurrent Avastin with 30 Gy of hypofractionated stereotactic radiotherapy. One patient did not receive radiotherapy due to concern of overexposure, and three others discontinued therapy due to toxicity. Patients with glioblastoma had an overall response rate of 50%, with a six-month progression-free survival. Median overall survival was 12.5 months, and one-year survival was 54%.
Comments: These data suggest that Avastin and radiation therapy can be safely administered concurrently, which paves the way for up-front trials of Avastin plus radiation therapy in patients with malignant gliomas.
Reference:
[1] Gutin PH, Iwamoto FM, Beal K, et al. Safety and efficacy of bevacizumab with hypofractionated stereotactic irradiation for recurrent malignant gliomas. International Journal of Radiation Oncology, Biology & Physics. 2009;75:156-163.
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