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Treatment of pediatric cerebral radiation necrosis: a systematic review
Abstract Cerebral radiation necrosis (CRN) is a toxicity of radiation therapy that can result in significant, potentially life-threatening neurologic deficits. Treatment for CRN has included surgical resection, corticosteroids, hyperbaric oxygen therapy (HBOT), and bevacizumab, but no consensus approach has been identified. We reviewed the available literature to evaluate efficacy of treatment approaches. Using methods specified in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines when possible, we conducted searches of Ovid MEDLINE, Embase and Pubmed to identify studies re...
Source: Journal of Neuro-Oncology - July 19, 2016 Category: Cancer & Oncology Source Type: research

Bevacizumab, temozolomide, and radiotherapy for newly diagnosed glioblastoma: comprehensive safety results during and after first-line therapy
Conclusion The safety profile was consistent with that expected from radiotherapy/temozolomide plus bevacizumab. The increased AE incidence with bevacizumab did not impact patients' ability to receive standard-of-care treatment or to undergo further surgery.
Source: Neuro-Oncology - June 6, 2016 Category: Cancer & Oncology Authors: Saran, F., Chinot, O. L., Henriksson, R., Mason, W., Wick, W., Cloughesy, T., Dhar, S., Pozzi, E., Garcia, J., Nishikawa, R. Tags: Clinical Investigations Source Type: research

Vascular complications in glioma patients.
Abstract Vascular complications in patients with glioma most commonly include venous and arterial thromboembolism; however, treatment-induced vasculopathies are also problematic, especially in long-term survivors. The interactions between treatment such as radiation and chemotherapy, the coagulation cascade, endothelium, and regulators of angiogenesis are complex, drive glioma growth and invasion, and create common management problems in the clinic. We review the incidence of thrombotic complications in glioma, the biology of the coagulome as related to glioma progression, prevention and treatment of thrombosis, t...
Source: Clinical Genitourinary Cancer - March 9, 2016 Category: Cancer & Oncology Authors: Le Rhun E, Perry JR Tags: Handb Clin Neurol Source Type: research

Ischemic stroke in patients with gliomas at The University of Texas-M.D. Anderson Cancer Center
Abstract Patients with gliomas are at risk of cerebrovascular accidents (CVA) with potential consequences on survival, function, and local tumor control. Our objective was to provide information about CVA in patients with gliomas and to estimate survival in this group. We reviewed all adult glioma patients with ischemic CVA at the University of Texas-M.D. Anderson Cancer Center from 2003 through 2014. We extracted demographic, clinical, imaging, treatment and outcome data. We used descriptive summary data and estimated or compared survival rates where appropriate. 60 of 6500 patients (0.1 %) with high-grade (HGG,...
Source: Journal of Neuro-Oncology - August 14, 2015 Category: Cancer & Oncology Source Type: research

Calcification in high grade gliomas treated with bevacizumab
Abstract Calcification is a rare phenomenon in high grade glioma (HGG). CT scans are sensitive to mineralization but used infrequently for tumor assessment in the MRI era. The presence of calcification can be overlooked on routine MRI. Calcification may reflect chronicity and natural changes in the tumor or its milieu over time and may be accelerated by certain treatments. Calcification may have clinical significance which could signal potential risk for stroke or hemorrhage related to particular therapies; or it may be a positive prognostic factor for treatment response. The true incidence and relevance of calcif...
Source: Journal of Neuro-Oncology - May 5, 2015 Category: Cancer & Oncology Source Type: research

Phase II trial of hypofractionated intensity-modulated radiation therapy combined with temozolomide and bevacizumab for patients with newly diagnosed glioblastoma
This study demonstrated 90 % 6-month PFS and OS comparable to historic data in patients receiving standard treatment. Bevacizumab did not prevent radiation necrosis associated with this hypofractionated radiation regimen and large PTV volumes may have contributed to high rates of presumed radiation necrosis.
Source: Journal of Neuro-Oncology - December 19, 2014 Category: Cancer & Oncology Source Type: research

Rt-08 * proton therapy (pt) large-volume re-irradiation for recurrent glioma: overall survival (os) and toxicity outcomes
CONCLUSION: Large-volume PT re-irradiation for recurrent glioma is safe and associated with promising OS outcomes, particularly in the setting of bevacizumab-refractory tumors.
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Desai, B., Rockne, R., Rademaker, A., Raizer, J., Paleologos, N., Merrell, R., Grimm, S., Azeem, S., Hartsell, W., Sweeney, P., Swanson, K., Gondi, V. Tags: RADIATION THERAPY (CLINICAL AND/OR LABORATORY RESEARCH) Source Type: research

Cn-14 * retrospective analysis of ischemic cerebral strokes in patients diagnosed with a glioblastoma during the course of a bevacizumab treatment
Bevacizumab is an anti-vascular endothelial growth factor approved in the treatment of recurrent glioblastoma. It prolongs progression-free survival, improes radiologic response and contributes to reduce the dose of dexamethasone required to control peritumoral edema. Arterial and venous thromboembolic events represent significant toxicities related to the use of angiogenesis inhibitors. Various mechanisms could be implicated in bevacizumab-related strokes, as cardioembolic, lacunar stroke related to hypertension, deep venous thrombosis passing through a patent foramen ovale, pro-coagulant effect of the underlying glioblas...
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Maurice, C., Mason, W. P. Tags: COMPLICATIONS OF THERAPY AND NEUROTOXICITY Source Type: research

Cn-15 * adverse effects of bevacizumab in brain tumor patients
CONCLUSION: The range of toxicities was similar to other reports. Interestingly, hypertension was the most common adverse effect and was often not treated. The high incidence of lymphocytopenia may have implications for combination with immunotherapies. These findings underscore the need to develop predictive models to identify patients at high risk for serious treatment-related toxicities.
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Pawar, T., Ladha, H., Mandel, J., Gilbert, M., O'Brien, B., Hamza, M., Armstrong, T. Tags: COMPLICATIONS OF THERAPY AND NEUROTOXICITY Source Type: research

Cn-20 * bevacizumab causing recurrent cerebral infarction in a patient with glioblastoma: a previously undocumented phenomenon
CONCLUSIONS: Here we describe a case of an ischemic stroke with radiographic correlate while on bevacizumab, with clinical improvement arrested by the development of a recurrent stroke when bevacizumab was restarted. Interestingly, the distal arteries within the stroke bed appeared somewhat attentuated, suggestive of radiation vasculopathy. This case, describing a previously undocumented phenomenon, raises the possibility of a synergistic effect of bevacizumab and radiation vasculopathy. It may be that radiation vasculoapthy alone is typically insufficient to cause ischemia, but the addition of bevacizumab may precipitate ...
Source: Neuro-Oncology - November 3, 2014 Category: Cancer & Oncology Authors: Winkel, D., Voloschin, A. Tags: COMPLICATIONS OF THERAPY AND NEUROTOXICITY Source Type: research

432p * patterns and efficacy of bevacizumab use across treatment lines in glioblastoma
Conclusions: Our results show bevacizumab treatment may be more efficient after a recurrence than when used in the beginning of treatment and are in line with reported registration trials data.Disclosure: All authors have declared no conflicts of interest.
Source: Annals of Oncology - September 24, 2014 Category: Cancer & Oncology Authors: Azam, M. B., Rho, Y. S., Mamo, A., Sahebjam, S., Muanza, T., Guiot, M., Al-Shami, J., Sharma, R., Kavan, P. Tags: CNS tumours Source Type: research

Contraindicated Use of Bevacizumab and Toxicity in Elderly Patients With Cancer Health Services and Outcomes
Conclusion Our study demonstrates widespread use of bevacizumab among patients who had contraindications. Black patients were less likely to receive the drug, but those who did were more likely to have a contraindication. Efforts to understand toxicity and efficacy in populations excluded from clinical trials are needed.
Source: Journal of Clinical Oncology - September 27, 2013 Category: Cancer & Oncology Authors: Hershman, Wright, Lim, Buono, Tsai, Neugut Tags: Quality of Care, Quality of Care Health Services and Outcomes Source Type: research

Contraindicated Use of Bevacizumab and Toxicity in Elderly Patients With Cancer.
CONCLUSION: Our study demonstrates widespread use of bevacizumab among patients who had contraindications. Black patients were less likely to receive the drug, but those who did were more likely to have a contraindication. Efforts to understand toxicity and efficacy in populations excluded from clinical trials are needed. PMID: 24002522 [PubMed - as supplied by publisher]
Source: Clinical Lung Cancer - September 3, 2013 Category: Cancer & Oncology Authors: Hershman DL, Wright JD, Lim E, Buono DL, Tsai WY, Neugut AI Tags: J Clin Oncol Source Type: research

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