Bevacizumab therapy for adults with recurrent/progressive meningioma: a retrospective series

Intracranial meningiomas are often indolent tumors which typically grow over years to decades. Nonetheless, meningiomas that progress after maximum safe resection and radiation therapy pose a significant therapeutic challenge and effective therapies have yet to be identified. Preclinical studies imp...

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Bibliographic Details
Published in:Journal of neuro-oncology 2012-08, Vol.109 (1), p.63-70
Main Authors: Lou, Emil, Sumrall, Ashley L., Turner, Scott, Peters, Katherine B., Desjardins, Annick, Vredenburgh, James J., McLendon, Roger E., Herndon, James E., McSherry, Frances, Norfleet, Julie, Friedman, Henry S., Reardon, David A.
Format: Article
Language:English
Subjects:
Adult
Aged
Angiogenesis
Angiogenesis Inhibitors - therapeutic use
Antibodies, Monoclonal, Humanized - therapeutic use
Bevacizumab
Central nervous system
Chemotherapy
Clinical Study
Clinical trials
Female
Follow-Up Studies
Hemorrhage
Humans
Intestine
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Meningeal Neoplasms - drug therapy
Meningeal Neoplasms - mortality
Meningeal Neoplasms - pathology
meningioma
Meningioma - drug therapy
Meningioma - mortality
Meningioma - pathology
Middle Aged
Monoclonal antibodies
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - pathology
Neoplasm Staging
Neurology
Oncology
Prognosis
Retrospective Studies
Survival
Survival Rate
Toxicity
Tumors
Vascular endothelial growth factor
Young Adult
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Summary:Intracranial meningiomas are often indolent tumors which typically grow over years to decades. Nonetheless, meningiomas that progress after maximum safe resection and radiation therapy pose a significant therapeutic challenge and effective therapies have yet to be identified. Preclinical studies implicate angiogenesis in the pathophysiology of more aggressive meningiomas, suggesting that anti-angiogenic therapies may be of utility in this setting. We performed a retrospective review of fourteen patients with recurrent meningioma treated at Duke University Medical Center with bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, administered either alone or in combination with chemotherapy. Most patients were heavily pre-treated. Progression-free survival at 6 months was 86 % and was comparable regardless of meningioma grade and whether bevacizumab was administered as monotherapy or in combination with chemotherapy. Most toxicities were mild however single patients developed CNS hemorrhage (grade 1) and intestinal perforation (grade 4), respectively. Bevacizumab can be administered safely to patients with meningioma and appears to be associated with encouraging anti-tumor effect when administered as either a single agent or in combination with chemotherapy. Phase II trials investigating bevacizumab in patients with progressive/recurrent meningioma are warranted.
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-012-0861-0