Abstract Details

Title Synergistic Efficacy of Bevacizumab and Corticosteroids in Progressive High Grade Gliomas - A Retrospective Study

Topic Neuro-oncology

Presentation(s) P01 - (-)

Poster/Presentation
Number 099

Objective

Background High grade glioma (HGG) is the most common malignant primary brain tumor in adults and is associated with poor prognosis despite recent therapeutic advances. Bev is an anti-vascular endothelial growth factor monoclonal antibody that inhibits angiogenesis in gliobalstomas that decreases tumor growth and tumor edema. Corticosteroids are used in the management of symptomatic vasogenic cerebral edema in rapidly growing tumors. Preliminary observations at our institution suggested that patients treated with Bev and concurrent Dex seem to show a more prominent radiographic response, at least during the first few cycles.

Design/Methods We performed an IRB-approved retrospective study of adults with HGG treated at the Emory Neuro-oncology Clinic with progressive disease requiring treatment with Bev with/without Dex. Patients who received bev plus other chemotherapeutics were excluded. Patients were divided into 2 groups: "Bev" and "Bev+Dex." Radiographic response was defined as response or stable disease noted on two consecutive MRI scans ? 4 weeks after initiation of therapy. RR rates and response duration were compared between the groups.

Results 54 patients with HGG with progressive disease were included. Baseline demographics were similar among both groups. Overall, 50% of all included patients showed RR. RR rate was higher in the Bev+Dex group compared to Bev patients (59% vs. 26% OR 3.95, 95% CI 1.1-14.7, p=0.03). Mean response duration was similar in both groups (Bev: 248±92 days, Bev+Dex: 216±36 days, p=0.37). Details of steroid dosage and taper schedules were not consistently available in the Bev+Dex group.

Conclusions Concurrent use of Dex with Bev increased rate of radiographic response to treatment without affecting duration of response showing a possible synergistic effect. Larger prospective studies are required to further study this effect.

Authors/Disclosures
Srikant Rangaraju, MBBS (Emory University, Atlanta) PRESENTER	Dr. Rangaraju has nothing to disclose.
Theodore Wein, MD (Montreal General Hospital)	No disclosure on file
Mohammad Khoshnoodi, MD (Tower Health)	No disclosure on file
Alfredo D. Voloschin, MD (Orlando Health Cancer Institute)	No disclosure on file

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