Article
Impressive tumor response to therapy with Bevacizumab and Irinotecan – an option in recurrent glioblastoma
Beeindruckende Tumorrückbildung unter Bevacizumab und Irinotecan – eine Therapieoption bei rezidivierendem Glioblastom
Search Medline for
Authors
-
Á. Oszvald
- Neurochirurgische Klinik, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
E. Hattingen
- Institut für Neruroradiologie, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
V. Seifert
- Neurochirurgische Klinik, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
-
K. Franz
- Neurochirurgische Klinik, Klinikum der Johann Wolfgang Goethe-Universität, Frankfurt am Main
| Published: | May 30, 2008 |
|---|
Outline
Text
Objective: We report on four patients with recurrent glioblastoma following repeated treatment for multiple recurrences. Confronted with another recurrence, a treatment with Bevacizumab and Irinotecan according to the phase II study of Friedman et al. (2007) was given to the patients as ultima ratio therapy.
Methods: All four patients with primary and secondary glioblastoma were treated in our clinic during their course of disease. Treatment of recurrences after standard therapy was discussed individually in every case, including reoperation, reiraddiation, brachytherapy and different chemotherapeutic protocols. Clinical deterioration and new neurological deficits corresponded with progressive tumor in magnetic resonance imaging (MRI).
Results: Three of our four patients responded with an impressive clinical improvement within four weeks. The first MRI control in these three patients showed a stable disease level in one and a tumor regression in two patients. The patient with stable disease developed clinical worsening corresponding to tumor progression in the MRI three months after onset of therapy. In the other two patients clinical improvement with regression of neurological deficits is continuing until now (4 and 12 months after onset of therapy). The subsequent MRI controls in both patients showed ongoing tumor regression with a decrease in contrast enhancement and a reduction of perifocal edema. Complications and adverse effects of Bevacizumab and Irinotecan did not occur.
Conclusions: In view of these positive results with clinical and MRI improvement, the combination of Bevacizumab and Irinotecan should be considered in recurrent glioblastoma after failure of standard therapy.
