Bevacizumab (=Avastin) plus Irinotecan

[Ulrich]

Quelle: J Clin Oncol. 2007 Oct 20;25(30):4722-9.
Zitat:
Bevacizumab plus irinotecan in recurrent glioblastoma multiforme.

Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Marcello J, Reardon DA, Quinn JA, Rich JN, Sathornsumetee S, Gururangan S, Sampson J, Wagner M, Bailey L, Bigner DD, Friedman AH, Friedman HS.
Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC 27710, USA. vrede001@mc.duke.edu

PURPOSE: The prognosis for patients with recurrent glioblastoma multiforme is poor, with a median survival of 3 to 6 months. We performed a phase II trial of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in combination with irinotecan. PATIENTS AND METHODS: This phase II trial included two cohorts of patients. The initial cohort, comprising 23 patients, received bevacizumab at 10 mg/kg plus irinotecan every 2 weeks. The dose of irinotecan was based on the patient's anticonvulsant: Patients taking enzyme-inducing antiepileptic drugs (EIAEDs) received 340 mg/m2, and patients not taking EIAEDs received 125 mg/m2. After this regimen was deemed safe and effective, the irinotecan schedule was changed to an accepted brain tumor regimen of four doses in 6 weeks, in anticipation of a phase III randomized trial of irinotecan versus irinotecan and bevacizumab. The second cohort, comprising 12 patients, received bevacizumab 15 mg/kg every 21 days and irinotecan on days 1, 8, 22, and 29. Each cycle was 6 weeks long and concluded with patient evaluations, including magnetic resonance imaging.
RESULTS: The 6-month progression-free survival among all 35 patients was 46% (95% CI, 32% to 66%). The 6-month overall survival was 77% (95% CI, 64% to 92%). Twenty of the 35 patients (57%; 95% CI, 39% to 74%) had at least a partial response. One patient developed a CNS hemorrhage, which occurred in his 10th cycle. Four patients developed thromboembolic complications (deep venous thrombosis and/or pulmonary emboli).
CONCLUSION: Bevacizumab and irinotecan is an effective treatment for recurrent glioblastoma multiforme and has moderate toxicity.

[Ulrich]

http://www.brainlife.org/treatment/bevacizumab.htm

What is the place of bevacizumab and irinotecan in the treatment of glioblastoma and other malignant gliomas?.

Efficacy, safety and patterns of response and recurrence in patients with recurrent high-grade gliomas treated with bevacizumab plus irinotecan.

Bevacizumab and irinotecan treatment for progressive diffuse brainstem glioma: case report

[KarlNapf]

Therapeutic Application of Noncytotoxic Molecular Targeted Therapy in Gliomas: Growth Factor Receptors and Angiogenesis Inhibitors

Oncologist. 2008 Sep;13(9):978-92
Therapeutic application of noncytotoxic molecular targeted therapy in gliomas: growth factor receptors and angiogenesis inhibitors.
Idbaih A, Ducray F, Sierra Del Rio M, Hoang-Xuan K, Delattre JY.

Es geht um die Anti-Angiogenese (also das Stoppen des Neuwachstums von "Versorgungsleitungen" zum Tumor) - mit Hilfe von Irinotecan und die Wachstumshemmung [vascular endothelial growth factor (VEGF)] durch einen spezifischen Antikörper [Bevacizumab].