Bevacizumab for recurrent ependymoma.

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2009 ASCO Annual Meeting
Abstract No: 2060 Citation: J Clin Oncol 27:15s, 2009 (suppl; abstr 2060)


Author(s):R. M. Green,
T. Cloughesy, R. Stupp, L. M. DeAngelis, E. A. Woyshner, D. E. Ney, A.
B. Lassman; Kaiser Foundation Hospital, Los Angeles, CA; University of
California, Los Angeles, Los Angeles, CA; University of Lausanne
Hospitals, Lausanne, Switzerland; Memorial Sloan-Kettering Cancer
Center, New York, NY
Ependymoma is a rare type of glioma, representing less than 5% of brain
tumors in adults. Radiotherapy (RT) is commonly administered, but there
is no standard chemotherapy. At recurrence ependymoma is notoriously
refractory to therapy and the prognosis is poor. In recurrent
glioblastoma, encouraging responses with bevacizumab have been
observed. Therefore, we treated patients with recurrent ependymoma and
anaplastic ependymoma with bevacizumab containing chemotherapy
Methods: We retrospectively identified adults treated
for recurrent ependymoma and anaplastic ependymoma with bevacizumab
containing chemotherapy regimens. We determined radiographic response
(Macdonald criteria) and estimated median time to progression (TTP) and
overall survival (OS) by the Kaplan-Meier method.
There were six patients, four women and two men, with a median age of
29 years (range, 20-65). Prior treatment included RT in all and
temozolomide in four. Bevacizumab (5-10 mg/kg) every other week was
combined with cytotoxic agents: irinotecan (3), carboplatin (2), or
temozolomide (1). Five patients achieved a partial response (83%); in
one patient the disease was stable. Median TTP and OS were 6.5 (95% CI:
2.7-10.2) and 9.4 (95% CI: 6.3-12.6) months, respectively, with a
median follow up of 18.7 months for the two surviving patients. One
additional patient is initiating bevacizumab monotherapy (not included
in this analysis).
Conclusions: Bevacizuamb has efficacy in the treatment of recurrent ependymoma. Prospective study is warranted.