Recurrent spinal cord glioblastoma: salvage therapy with bevacizumab

• DOI: 10.1007/s11060-010-0330-6
• Publication Date: 2010-07-31T16:36:48Z
• Authors: Marc C. Chamberlain; Sandra K. Johnston
• Keywords: Adult; Male; Salvage Therapy; Antibodies, Monoclonal; Angiogenesis Inhibitors; Middle Aged; Antibodies, Monoclonal, Humanized; Magnetic Resonance Imaging; 3. Good health; Bevacizumab; Young Adult; 03 medical and health sciences; Treatment Outcome; 0302 clinical medicine; Humans; Female; Spinal Cord Neoplasms; Neoplasm Recurrence, Local; Glioblastoma; Retrospective Studies

Primary spinal cord tumors constitute 2-4% of all primary central nervous system malignancies in adults of which less than 5% are glioblastoma. A retrospective evaluation to determine toxicity and response to bevacizumab in patients with recurrent spinal cord glioblastoma. Six patients (4 males; 2 females: median age 34 years) with recurrent spinal cord glioblastoma were treated with bevacizumab (10 mg/kg given once every 2 weeks wherein 2 treatments constituted a cycle of therapy). All patients had failed surgery and temozolomide-based chemoradiotherapy and post-radiotherapy temozolomide. Blood counts, chemistry panel, urine protein to creatinine ratio and neurologic examination were obtained bi-weekly. Contrast-enhanced spine MRI was performed after one cycle of therapy and thereafter following every two cycles of bevacizumab. Treatment-related complications included fatigue in six patients, constipation in 4, hypertension in 2, venous thrombosis in 2, and infection without neutropenia in 2. There were three grade 3 toxicities (1 each fatigue, leukopenia and venous thrombosis). There were no treatment-related deaths. After one cycle of bevacizumab, one patient (17%) demonstrated progressive disease, 2 (34%) partial responses and three (51%) stable disease. Overall median response or stable disease duration (disease free progression) was 7 months (range 3-11 months). Overall median survival was 9 months (range of 5-13 months). Bevacizumab is well tolerated, has tolerable toxicity and apparent activity in this small cohort of adults with recurrent spinal cord glioblastoma.