Abstract Details

Title Treatment of Unresectable Adult Pilocytic Astrocytoma with Bevacizumab with or without Temozolomide

Topic Neuro-oncology

Presentation(s) P01 - (-)

Poster/Presentation
Number 097

Objective

Background PA is a WHO Grade I tumor that is often not completely resectable. TMZ, an alkylating agent, and bev, a blocker of vascular endothelial growth factor (VEGF), are both approved for treatment of glioblastoma. Pathological studies have shown VEGF expression in PA.

Design/Methods We reviewed cases of unresectable PA treated with bev with or without TMZ. We identified 11 patients, 6 male and 5 female, with a median age of 31 years. Six were hypothalamic, 2 thalamic, 2 pineal, and 1 midbrain. Three patients were treated in the up-front setting, and 8 were treated for progression after radiation therapy. Four patients had received prior chemotherapy, 2 with TMZ and 1 each PCV and carboplatin. Treatment consisted of bev 5 mg/kg every 14-21 days, with or without TMZ 150-200 mg/sq m every 5 of 28 days. MR scans were graded according to Macdonald criteria.

Results Seven patients were treated with TMZ plus bev and 4 with bev monotherapy. Median duration of therapy was 494 days for bev and 281 days for TMZ. Ten patients (91%) achieved a partial response and 1 no response. Cyst volumes were decreased in 6 of 7 tumors (86%) with multicystic change. Visual field or extraocular movement deficits improved significantly in 5 patients. One patient experienced symptomatic intratumoral hemorrhage. One patient died after craniotomy for hemorrhagic tumor progression. Only 1 patient progressed on bev. Median time to progression on bev was 575 days.

Conclusions Bev when administered with or without TMZ is effective in unresectable adult PA and deserves a Phase II study.

Authors/Disclosures
Richard M. Green, MD, FAAN (Kaiser Permanente) PRESENTER	No disclosure on file
Emily A. Woyshner, RPA-C (Kaiser Permanente)	No disclosure on file
	No disclosure on file
	No disclosure on file
Timothy F. Cloughesy, MD	Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for BlueRock. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vida Ventures. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Lista Therapeutics. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Stemline. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Roche. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sonalasense. Dr. Cloughesy has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Servier. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sagimet. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Jubilant. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Gan & Lee. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Brainstorm. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sapience. Dr. Cloughesy has received personal compensation in the range of $0-$499 for serving as a Consultant for Inovio. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for DNATrix. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Tyme. Dr. Cloughesy has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for Kintara. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Bayer. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Merck. Dr. Cloughesy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Boehringer Ingelheim. Dr. Cloughesy has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Kiyatec. Dr. Cloughesy has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Chimerix. Dr. Cloughesy has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Katmai. Dr. Cloughesy has received personal compensation in the range of $50,000-$99,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Break Through Cancer. Dr. Cloughesy has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Kintara. Dr. Cloughesy has received personal compensation in the range of $10,000-$49,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Chimerix. Dr. Cloughesy has received personal compensation in the range of $50,000-$99,999 for serving as an officer or member of the Board of Directors for Katmai. Dr. Cloughesy has stock in Katmai. Dr. Cloughesy has stock in Chimerix. Dr. Cloughesy has received intellectual property interests from a discovery or technology relating to health care. Dr. Cloughesy has received intellectual property interests from a discovery or technology relating to health care. Dr. Cloughesy has received intellectual property interests from a discovery or technology relating to health care.
Glenn A. Phillips, PhD	Dr. Phillips has received personal compensation for serving as an employee of argenx. Dr. Phillips has stock in argenx.

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