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Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas.

Publication ,  Journal Article
Vredenburgh, JJ; Desjardins, A; Herndon, JE; Quinn, J; Rich, J; Sathornsumetee, S; Friedman, HS; Reardon, D; Gururangan, S; Friedman, A
Published in: J Clin Oncol
June 20, 2006

1506 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/m(2) for patients not taking enzyme inducing anti-epileptic drugs or 340 mg/m(2) 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. [Table: see text].

Duke Scholars

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 20, 2006

Volume

24

Issue

18_suppl

Start / End Page

1506

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Vredenburgh, J. J., Desjardins, A., Herndon, J. E., Quinn, J., Rich, J., Sathornsumetee, S., … Friedman, A. (2006). Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas. J Clin Oncol, 24(18_suppl), 1506.
Vredenburgh, J. J., A. Desjardins, J. E. Herndon, J. Quinn, J. Rich, S. Sathornsumetee, H. S. Friedman, D. Reardon, S. Gururangan, and A. Friedman. “Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas.J Clin Oncol 24, no. 18_suppl (June 20, 2006): 1506.
Vredenburgh JJ, Desjardins A, Herndon JE, Quinn J, Rich J, Sathornsumetee S, et al. Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas. J Clin Oncol. 2006 Jun 20;24(18_suppl):1506.
Vredenburgh, J. J., et al. “Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas.J Clin Oncol, vol. 24, no. 18_suppl, June 2006, p. 1506.
Vredenburgh JJ, Desjardins A, Herndon JE, Quinn J, Rich J, Sathornsumetee S, Friedman HS, Reardon D, Gururangan S, Friedman A. Bevacizumab, a monoclonal antibody to vascular endothelial growth factor (VEGF), and irinotecan for treatment of malignant gliomas. J Clin Oncol. 2006 Jun 20;24(18_suppl):1506.

Published In

J Clin Oncol

EISSN

1527-7755

Publication Date

June 20, 2006

Volume

24

Issue

18_suppl

Start / End Page

1506

Location

United States

Related Subject Headings

  • Oncology & Carcinogenesis
  • 1112 Oncology and Carcinogenesis
  • 1103 Clinical Sciences