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  1. Article ; Online: Novel medical therapeutics in glioblastomas, including targeted molecular therapies, current and future clinical trials.

    Quant, Eudocia C / Wen, Patrick Y

    Neuroimaging clinics of North America

    2010  Volume 20, Issue 3, Page(s) 425–448

    Abstract: The prognosis for glioblastoma is poor despite optimal therapy with surgery, radiation, and chemotherapy. New therapies that improve survival and quality of life are needed. Research has increased our understanding of the molecular pathways important for ...

    Abstract The prognosis for glioblastoma is poor despite optimal therapy with surgery, radiation, and chemotherapy. New therapies that improve survival and quality of life are needed. Research has increased our understanding of the molecular pathways important for gliomagenesis and disease progression. Novel agents have been developed against these targets, including receptor tyrosine kinases, intracellular signaling molecules, epigenetic abnormalities, and tumor vasculature and microenvironment. This article reviews novel therapies for glioblastoma, with an emphasis on targeted agents.
    MeSH term(s) Brain Neoplasms/complications ; Brain Neoplasms/drug therapy ; Brain Neoplasms/therapy ; Clinical Trials as Topic/methods ; Clinical Trials as Topic/trends ; Glioblastoma/complications ; Glioblastoma/drug therapy ; Glioblastoma/therapy ; Humans ; Molecular Targeted Therapy/methods ; Molecular Targeted Therapy/trends ; Neovascularization, Pathologic/complications ; Neovascularization, Pathologic/drug therapy
    Language English
    Publishing date 2010-08
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 1314594-0
    ISSN 1557-9867 ; 1052-5149
    ISSN (online) 1557-9867
    ISSN 1052-5149
    DOI 10.1016/j.nic.2010.04.007
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Response assessment in neuro-oncology.

    Quant, Eudocia C / Wen, Patrick Y

    Current oncology reports

    2010  Volume 13, Issue 1, Page(s) 50–56

    Abstract: Accuracy and reproducibility in determining response to therapy and tumor progression can be difficult to achieve for nervous system tumors. Current response criteria vary depending on the pathology and have several limitations. Until recently, the most ... ...

    Abstract Accuracy and reproducibility in determining response to therapy and tumor progression can be difficult to achieve for nervous system tumors. Current response criteria vary depending on the pathology and have several limitations. Until recently, the most widely used criteria for gliomas were "Macdonald criteria," based on two-dimensional tumor measurements on neuroimaging studies. However, the Response Assessment in Neuro-Oncology (RANO) Working Group has published new recommendations in high-grade gliomas and is working on recommendations for other nervous system tumors. This article reviews current response criteria for high-grade glioma, low-grade glioma, brain metastasis, meningioma, and schwannoma.
    MeSH term(s) Brain Neoplasms/diagnosis ; Brain Neoplasms/pathology ; Brain Neoplasms/secondary ; Brain Neoplasms/therapy ; Diagnostic Imaging/methods ; Disease Progression ; Glioma/diagnosis ; Glioma/pathology ; Glioma/secondary ; Glioma/therapy ; Humans ; Nervous System Neoplasms/diagnosis ; Nervous System Neoplasms/pathology ; Nervous System Neoplasms/therapy ; Practice Guidelines as Topic
    Language English
    Publishing date 2010-11-18
    Publishing country United States
    Document type Journal Article ; Review
    ZDB-ID 2057359-5
    ISSN 1534-6269 ; 1523-3790
    ISSN (online) 1534-6269
    ISSN 1523-3790
    DOI 10.1007/s11912-010-0143-y
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Phase 2 study of pembrolizumab in patients with recurrent and residual high-grade meningiomas

    Priscilla K. Brastianos / Albert E. Kim / Anita Giobbie-Hurder / Eudocia Quant Lee / Nancy Wang / April F. Eichler / Ugonma Chukwueke / Deborah A. Forst / Isabel C. Arrillaga-Romany / Jorg Dietrich / Zachary Corbin / Jennifer Moliterno / Joachim Baehring / Michael White / Kevin W. Lou / Juliana Larson / Magali A. de Sauvage / Kathryn Evancic / Joana Mora /
    Naema Nayyar / Jay Loeffler / Kevin Oh / Helen A. Shih / William T. Curry / Daniel P. Cahill / Fred G. Barker / Elizabeth R. Gerstner / Sandro Santagata

    Nature Communications, Vol 13, Iss 1, Pp 1-

    2022  Volume 7

    Abstract: Abstract High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to ... ...

    Abstract Abstract High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to their aggressive phenotype. Here, we present the results of a single-arm, open-label phase 2 trial (NCT03279692) evaluating the efficacy of pembrolizumab, a PD-1 inhibitor, in a cohort of 25 evaluable patients with recurrent and progressive grade 2 and 3 meningiomas. The primary endpoint is the proportion of patients alive and progression-free at 6 months (PFS-6). Secondary endpoints include progression-free and overall survival, best intracranial response, and toxicity. Our study has met its primary endpoint and achieved a PFS-6 rate of 0.48 (90% exact CI: 0.31–0.66) and a median PFS of 7.6 months (90% CI: 3.4–12.9 months). Twenty percent of patients have experienced one (or more) grade-3 or higher treatment-related adverse events. These results suggest that pembrolizumab exerts promising efficacy on a subset of these tumors. Further studies are needed to identify the biological facets within the meningioma TME that may drive response to immune-based therapies.
    Keywords Science ; Q
    Subject code 610
    Language English
    Publishing date 2022-03-01T00:00:00Z
    Publisher Nature Portfolio
    Document type Article ; Online
    Database BASE - Bielefeld Academic Search Engine (life sciences selection)

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  4. Article: Neurologic complications of cancer drug therapies.

    Lee, Eudocia Quant / Arrillaga-Romany, Isabel C / Wen, Patrick Y

    Continuum (Minneapolis, Minn.)

    2012  Volume 18, Issue 2, Page(s) 355–365

    Abstract: Purpose of review: The purpose of this article is to review neurologic complications associated with systemic anticancer therapies.: Recent findings: Although neurologic complications from traditional chemotherapies are well described, most ... ...

    Abstract Purpose of review: The purpose of this article is to review neurologic complications associated with systemic anticancer therapies.
    Recent findings: Although neurologic complications from traditional chemotherapies are well described, most neurologists are less familiar with complications from agents that target specific pathways or receptors. This article also reviews the most common neurologic adverse effects associated with newer targeted agents.
    Summary: Patients with cancer are living longer because of earlier diagnoses and remarkable improvements in treatments. Unfortunately, both traditional chemotherapies and newer targeted agents are known to cause neurologic symptoms that can impact quality of life and play a role in limiting potential treatments. Acute, subacute, and chronic syndromes may affect the central or peripheral nervous system. Since treatments for therapy-induced neurotoxicity are limited, awareness of common neurologic complications is important to prevent permanent damage.
    MeSH term(s) Aged ; Antineoplastic Agents/adverse effects ; Female ; Humans ; Male ; Middle Aged ; Neoplasms/drug therapy ; Nervous System/drug effects ; Nervous System Diseases/chemically induced ; Neurotoxicity Syndromes/etiology
    Chemical Substances Antineoplastic Agents
    Language English
    Publishing date 2012-04
    Publishing country United States
    Document type Case Reports ; Journal Article ; Review
    ISSN 1080-2371
    ISSN 1080-2371
    DOI 10.1212/01.CON.0000413663.42798.64
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Phase 2 study of pembrolizumab in patients with recurrent and residual high-grade meningiomas.

    Brastianos, Priscilla K / Kim, Albert E / Giobbie-Hurder, Anita / Lee, Eudocia Quant / Wang, Nancy / Eichler, April F / Chukwueke, Ugonma / Forst, Deborah A / Arrillaga-Romany, Isabel C / Dietrich, Jorg / Corbin, Zachary / Moliterno, Jennifer / Baehring, Joachim / White, Michael / Lou, Kevin W / Larson, Juliana / de Sauvage, Magali A / Evancic, Kathryn / Mora, Joana /
    Nayyar, Naema / Loeffler, Jay / Oh, Kevin / Shih, Helen A / Curry, William T / Cahill, Daniel P / Barker, Fred G / Gerstner, Elizabeth R / Santagata, Sandro

    Nature communications

    2022  Volume 13, Issue 1, Page(s) 1325

    Abstract: High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to their ... ...

    Abstract High-grade meningiomas are associated with neuro-cognitive morbidity and have limited treatments. High-grade meningiomas harbor an immunosuppressive tumor microenvironment (TME) and programmed death-ligand 1 (PD-L1) expression may contribute to their aggressive phenotype. Here, we present the results of a single-arm, open-label phase 2 trial (NCT03279692) evaluating the efficacy of pembrolizumab, a PD-1 inhibitor, in a cohort of 25 evaluable patients with recurrent and progressive grade 2 and 3 meningiomas. The primary endpoint is the proportion of patients alive and progression-free at 6 months (PFS-6). Secondary endpoints include progression-free and overall survival, best intracranial response, and toxicity. Our study has met its primary endpoint and achieved a PFS-6 rate of 0.48 (90% exact CI: 0.31-0.66) and a median PFS of 7.6 months (90% CI: 3.4-12.9 months). Twenty percent of patients have experienced one (or more) grade-3 or higher treatment-related adverse events. These results suggest that pembrolizumab exerts promising efficacy on a subset of these tumors. Further studies are needed to identify the biological facets within the meningioma TME that may drive response to immune-based therapies.
    MeSH term(s) Antibodies, Monoclonal, Humanized/adverse effects ; Disease Progression ; Humans ; Meningeal Neoplasms/drug therapy ; Meningioma/drug therapy ; Tumor Microenvironment
    Chemical Substances Antibodies, Monoclonal, Humanized ; pembrolizumab (DPT0O3T46P)
    Language English
    Publishing date 2022-03-14
    Publishing country England
    Document type Clinical Trial, Phase II ; Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2553671-0
    ISSN 2041-1723 ; 2041-1723
    ISSN (online) 2041-1723
    ISSN 2041-1723
    DOI 10.1038/s41467-022-29052-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Recurrent high-grade glioma.

    Quant, Eudocia C / Drappatz, Jan / Wen, Patrick Y / Norden, Andrew D

    Current treatment options in neurology

    2010  Volume 12, Issue 4, Page(s) 321–333

    Abstract: Opinion statement: Opinions vary on the best treatment options for recurrent high-grade glioma. Some argue that bevacizumab should become standard of care for patients with recurrent glioblastoma, especially in light of recent FDA approval for this ... ...

    Abstract Opinion statement: Opinions vary on the best treatment options for recurrent high-grade glioma. Some argue that bevacizumab should become standard of care for patients with recurrent glioblastoma, especially in light of recent FDA approval for this indication. However, this opinion is not uniformly accepted. Age, performance status, histology, tumor size and location, O6-methylguanine-DNA methyltransferase (MGMT) methylation status for glioblastoma, 1p/19q status for oligodendroglial tumors, and the number and types of prior therapies are important considerations. In addition, recurrent disease must be distinguished from "pseudoprogression" due to treatment effects. Enrollment in a clinical trial is the optimal choice for most patients with recurrent high-grade glioma after failure of radiation therapy and temozolomide. For patients who are ineligible or do not have access to clinical trials, then either bevacizumab monotherapy or bevacizumab in combination with a second agent such as irinotecan is recommended. Involved-field external beam radiation should be considered for patients with anaplastic gliomas who have not received radiation. For patients with anaplastic astrocytoma who progress after radiotherapy, temozolomide may be used. For patients with anaplastic oligodendroglioma who progress after radiotherapy, PCV chemotherapy and temozolomide are options. Oligodendroglial tumors with 1p/19q deletions are more likely to respond to treatment. In the past, carmustine was commonly used to treat recurrent high-grade glioma, but the utility of carmustine in the modern era is unknown because most studies were performed prior to the widespread use of temozolomide. High-precision re-irradiation such as stereotactic radiosurgery is another option in high-grade glioma, especially for patients with poor bone marrow reserve or inability to tolerate chemotherapy, but there is a paucity of studies with adequate controls. Surgery may be useful as adjuvant treatment for patients with symptoms due to mass effect or for patients requiring definitive histopathology, but it generally should be combined with another treatment modality. Emerging therapies, including dose-intense temozolomide regimens, targeted molecular inhibitors, other antiangiogenic therapies, viral gene therapies, immunotherapies, and convection-enhanced delivery of targeted immunotoxins, are still under investigation.
    Language English
    Publishing date 2010-09-15
    Publishing country United States
    Document type Journal Article
    ZDB-ID 2057342-X
    ISSN 1534-3138 ; 1092-8480
    ISSN (online) 1534-3138
    ISSN 1092-8480
    DOI 10.1007/s11940-010-0078-5
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Clinical trial links oncolytic immunoactivation to survival in glioblastoma.

    Ling, Alexander L / Solomon, Isaac H / Landivar, Ana Montalvo / Nakashima, Hiroshi / Woods, Jared K / Santos, Andres / Masud, Nafisa / Fell, Geoffrey / Mo, Xiaokui / Yilmaz, Ayse S / Grant, James / Zhang, Abigail / Bernstock, Joshua D / Torio, Erickson / Ito, Hirotaka / Liu, Junfeng / Shono, Naoyuki / Nowicki, Michal O / Triggs, Daniel /
    Halloran, Patrick / Piranlioglu, Raziye / Soni, Himanshu / Stopa, Brittany / Bi, Wenya Linda / Peruzzi, Pierpaolo / Chen, Ethan / Malinowski, Seth W / Prabhu, Michael C / Zeng, Yu / Carlisle, Anne / Rodig, Scott J / Wen, Patrick Y / Lee, Eudocia Quant / Nayak, Lakshmi / Chukwueke, Ugonma / Gonzalez Castro, L Nicolas / Dumont, Sydney D / Batchelor, Tracy / Kittelberger, Kara / Tikhonova, Ekaterina / Miheecheva, Natalia / Tabakov, Dmitry / Shin, Nara / Gorbacheva, Alisa / Shumskiy, Artemy / Frenkel, Felix / Aguilar-Cordova, Estuardo / Aguilar, Laura K / Krisky, David / Wechuck, James / Manzanera, Andrea / Matheny, Chris / Tak, Paul P / Barone, Francesca / Kovarsky, Daniel / Tirosh, Itay / Suvà, Mario L / Wucherpfennig, Kai W / Ligon, Keith / Reardon, David A / Chiocca, E Antonio

    Nature

    2023  Volume 623, Issue 7985, Page(s) 157–166

    Abstract: Immunotherapy failures can result from the highly suppressive tumour microenvironment that characterizes aggressive forms of cancer such as recurrent glioblastoma (rGBM) ...

    Abstract Immunotherapy failures can result from the highly suppressive tumour microenvironment that characterizes aggressive forms of cancer such as recurrent glioblastoma (rGBM)
    MeSH term(s) Humans ; Brain Neoplasms/immunology ; Brain Neoplasms/pathology ; Glioblastoma/immunology ; Glioblastoma/pathology ; Nestin/genetics ; Oncolytic Virotherapy/adverse effects ; Oncolytic Viruses/genetics ; Oncolytic Viruses/immunology ; Oncolytic Viruses/physiology ; Reproducibility of Results ; Survival Analysis ; T-Lymphocytes/cytology ; T-Lymphocytes/immunology ; Treatment Outcome ; Tumor Microenvironment/immunology ; Herpesvirus 1, Human/genetics ; Herpesvirus 1, Human/immunology ; Herpesvirus 1, Human/physiology
    Chemical Substances gamma 34.5 protein, Human herpesvirus 1 ; Nestin
    Language English
    Publishing date 2023-10-18
    Publishing country England
    Document type Clinical Trial, Phase I ; Journal Article
    ZDB-ID 120714-3
    ISSN 1476-4687 ; 0028-0836
    ISSN (online) 1476-4687
    ISSN 0028-0836
    DOI 10.1038/s41586-023-06623-2
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  8. Article ; Online: Salvage stereotactic radiosurgery for breast cancer brain metastases: outcomes and prognostic factors.

    Kelly, Paul J / Lin, Nancy U / Claus, Elizabeth B / Quant, Eudocia C / Weiss, Stephanie E / Alexander, Brian M

    Cancer

    2012  Volume 118, Issue 8, Page(s) 2014–2020

    Abstract: Background: Salvage stereotactic radiosurgery (SRS) is often considered in breast cancer patients previously treated for brain metastases. The goal of this study was to analyze clinical outcomes and prognostic factors for survival in the salvage setting. ...

    Abstract Background: Salvage stereotactic radiosurgery (SRS) is often considered in breast cancer patients previously treated for brain metastases. The goal of this study was to analyze clinical outcomes and prognostic factors for survival in the salvage setting.
    Methods: The authors retrospectively examined 79 consecutive breast cancer patients who received salvage SRS (interval of >3 months after initial therapy), 76 of whom (96%) received prior whole-brain radiation therapy. Overall survival (OS) and central nervous system (CNS) progression-free survival rates were calculated from the date of SRS using the Kaplan-Meier method. Prognostic factors were evaluated using the Cox proportional hazards model.
    Results: Median age was 50.5 years. Fifty-eight percent of this population was estrogen receptor positive, 62% was HER2 positive, and 10% was triple negative. At the time of SRS, 95% had extracranial metastases, with 81% of extracranial metastases at other visceral sites (lung/pleura/liver). Forty-eight percent had stable extracranial disease. Median interval from initial brain metastases therapy to SRS was 8.4 months. Median CNS progression-free survival after SRS was 5.7 months (interquartile range [IQR], 3.6-11 months), and median OS was 9.8 months (IQR, 3.8-18 months). Eighty-two percent of evaluable patients received further systemic therapy after SRS. HER2 status (adjusted hazard ratio [HR], 2.4; P = .008) and extracranial disease status (adjusted HR, 2.7; P = .004) were significant prognostic factors for survival on multivariate analysis.
    Conclusions: In patients with good Karnofsky performance status, salvage SRS for breast cancer brain metastases is a reasonable treatment option, given an associated median survival in excess of 9 months. Furthermore, patients with HER2-positive tumors at diagnosis or stable extracranial disease at the time of SRS have an improved clinical course, with median survival of >1 year.
    MeSH term(s) Adult ; Brain Neoplasms/mortality ; Brain Neoplasms/radiotherapy ; Brain Neoplasms/secondary ; Breast Neoplasms/pathology ; Breast Neoplasms/radiotherapy ; Female ; Humans ; Middle Aged ; Prognosis ; Radiosurgery/methods ; Retrospective Studies ; Salvage Therapy ; Treatment Outcome
    Language English
    Publishing date 2012-04-15
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.26343
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Phase 2 and biomarker study of trebananib, an angiopoietin-blocking peptibody, with and without bevacizumab for patients with recurrent glioblastoma.

    Reardon, David A / Lassman, Andrew B / Schiff, David / Yunus, Shakeeb A / Gerstner, Elizabeth R / Cloughesy, Timothy F / Lee, Eudocia Quant / Gaffey, Sarah C / Barrs, Jennifer / Bruno, Jennifer / Muzikansky, Alona / Duda, Daniel G / Jain, Rakesh K / Wen, Patrick Y

    Cancer

    2017  Volume 124, Issue 7, Page(s) 1438–1448

    Abstract: Background: Angiopoietins contribute to tumor angiogenesis and may be upregulated as a compensatory factor after vascular endothelial growth factor (VEGF) blockade. The authors performed a phase 2 and biomarker study to evaluate trebananib, an ... ...

    Abstract Background: Angiopoietins contribute to tumor angiogenesis and may be upregulated as a compensatory factor after vascular endothelial growth factor (VEGF) blockade. The authors performed a phase 2 and biomarker study to evaluate trebananib, an angiopoietin 1 and angiopoietin 2 blocking peptibody, with and without bevacizumab in patients with recurrent glioblastoma.
    Methods: Forty-eight patients who had bevacizumab-naive, recurrent glioblastoma were treated with trebananib (30 mg/kg weekly) as single agent (n = 11) or combined with bevacizumab (n = 37). The primary endpoint was 6-month progression-free survival rate as determined by investigator review. Circulating biomarker levels were assessed before and after study therapy.
    Results: Trebananib was well tolerated as monotherapy and did not enhance bevacizumab-associated toxicity. Trebananib had no single-agent activity, and all treated patients exhibited progressive disease within 2 months. The 6-month progression-free survival rate for trebananib plus bevacizumab was 24.3% (95% confidence interval [CI], 12.1%-38.8%); whereas the median overall survival was 9.5 months (95% CI, 7.5-4.7 months), and the 12-month overall survival rate was 37.8% (95% CI, 22.6%-53.0%). Baseline and post-treatment changes in circulating vascular VEGF and interleukin-8 levels were correlated with survival among patients who received trebananib plus bevacizumab.
    Conclusions: Angiopoietin 1 and angiopoietin 2 inhibition with trebananib was ineffective as monotherapy and did not enhance the ability of VEGF blockade with bevacizumab to improve the outcomes of patients with recurrent glioblastoma. Cancer 2018;124:1438-48. © 2017 American Cancer Society.
    MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Angiopoietins/antagonists & inhibitors ; Angiopoietins/metabolism ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bevacizumab/administration & dosage ; Biomarkers, Tumor/metabolism ; Cohort Studies ; Female ; Follow-Up Studies ; Glioblastoma/drug therapy ; Glioblastoma/metabolism ; Glioblastoma/pathology ; Humans ; Male ; Middle Aged ; Neoplasm Recurrence, Local/drug therapy ; Neoplasm Recurrence, Local/metabolism ; Neoplasm Recurrence, Local/pathology ; Prognosis ; Recombinant Fusion Proteins/administration & dosage ; Survival Rate
    Chemical Substances Angiopoietins ; Biomarkers, Tumor ; Recombinant Fusion Proteins ; Bevacizumab (2S9ZZM9Q9V) ; trebananib (X8Y5U6NC7E)
    Language English
    Publishing date 2017-12-19
    Publishing country United States
    Document type Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Research Support, Non-U.S. Gov't
    ZDB-ID 1429-1
    ISSN 1097-0142 ; 0008-543X ; 1934-662X
    ISSN (online) 1097-0142
    ISSN 0008-543X ; 1934-662X
    DOI 10.1002/cncr.31172
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  10. Article ; Online: Bevacizumab salvage therapy following progression in high-grade glioma patients treated with VEGF receptor tyrosine kinase inhibitors.

    Scott, Brian J / Quant, Eudocia C / McNamara, Margaret B / Ryg, Peter A / Batchelor, Tracy T / Wen, Patrick Y

    Neuro-oncology

    2010  Volume 12, Issue 6, Page(s) 603–607

    Abstract: Agents targeting the vascular endothelial growth factor (VEGF) pathway are being used with increasing frequency in patients with recurrent high-grade glioma. The effect of more than one antiangiogenic therapy given in succession has not been established. ...

    Abstract Agents targeting the vascular endothelial growth factor (VEGF) pathway are being used with increasing frequency in patients with recurrent high-grade glioma. The effect of more than one antiangiogenic therapy given in succession has not been established. We reviewed the efficacy of bevacizumab, a VEGF-A monoclonal antibody, in patients who progressed following prior therapy with VEGF receptor tyrosine kinase inhibitors (R-TKi). Seventy-three patients with recurrent high-grade gliomas received VEGF R-TKi (cediranib, sorafenib, pazopanib, or sunitinib) as part of phase I or II clinical trials. Twenty-four of these patients with glioblastoma progressed and received bevacizumab-containing regimens immediately after R-TKi. Those who stopped R-TKi therapy for reasons other than disease progression, or received a treatment that did not include bevacizumab, were excluded from the analysis. The efficacy of bevacizumab-containing regimens in these 24 patients was evaluated. During R-TKi therapy, 6 of 24 patients (25%) had a partial response (PR) to treatment. The 6-month progression-free survival (APF6) was 16.7% and median time-to-progression (TTP) was 14.3 weeks. Grade III/IV toxicities were seen in 13 of 24 patients (54%). Subsequently with bevacizumab salvage therapy, 5 of 24 patients (21%) had a PR, the APF6 was 12.5%, and the median TTP was 8 weeks. Five of 24 patients had grade III/IV toxicities (21%). The median overall survival (OS) from the start of R-TKi therapy was 9.2 months (range: 2.8-34.1+), whereas the median OS after bevacizumab was 5.2 months (range: 1.3-28.9+). Bevacizumab retains modest activity in high-grade glioma patients who progress on R-TKi. However, the APF6 of 12.5% in this cohort of patients indicates that durable tumor control is not achieved for most patients.
    MeSH term(s) Adult ; Aged ; Antibodies, Monoclonal/administration & dosage ; Antibodies, Monoclonal, Humanized ; Bevacizumab ; Brain Neoplasms/drug therapy ; Brain Neoplasms/enzymology ; Brain Neoplasms/pathology ; Disease Progression ; Female ; Glioma/drug therapy ; Glioma/enzymology ; Glioma/pathology ; Humans ; Male ; Middle Aged ; Neoplasm Staging/methods ; Receptor Protein-Tyrosine Kinases/antagonists & inhibitors ; Receptor Protein-Tyrosine Kinases/metabolism ; Receptors, Vascular Endothelial Growth Factor/antagonists & inhibitors ; Receptors, Vascular Endothelial Growth Factor/metabolism ; Retrospective Studies ; Salvage Therapy/methods ; Young Adult
    Chemical Substances Antibodies, Monoclonal ; Antibodies, Monoclonal, Humanized ; Bevacizumab (2S9ZZM9Q9V) ; Receptor Protein-Tyrosine Kinases (EC 2.7.10.1) ; Receptors, Vascular Endothelial Growth Factor (EC 2.7.10.1)
    Language English
    Publishing date 2010-02-14
    Publishing country England
    Document type Clinical Trial, Phase I ; Clinical Trial, Phase II ; Comparative Study ; Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 2028601-6
    ISSN 1523-5866 ; 1522-8517
    ISSN (online) 1523-5866
    ISSN 1522-8517
    DOI 10.1093/neuonc/nop073
    Database MEDical Literature Analysis and Retrieval System OnLINE

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