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Add-on-therapy with bevacizumab in children and adolescents with poor prognosis non-CNS solid tumors

Pansy, Jasmina; Fritsch, Peterb; Sovinz, Petraa; Lackner, Herwiga; Schwinger, Wolfganga; Urban, Christiana; Benesch, Martina

doi: 10.1097/CAD.0b013e32835b9589
CLINICAL REPORTS
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Bevacizumab is increasingly being used in adult patients with cancer and children with central nervous system (CNS) tumors. Little, however, is known about the efficacy, risks, and benefits of bevacizumab administration in non-CNS tumors of childhood. The aim of the present study was to report on bevacizumab administered as add-on-therapy for poor prognosis non-CNS solid tumors of childhood and adolescence, including a prospective evaluation of side effects of bevacizumab. Seven patients (female: n=5; median age, 14.5 years) with relapsed (n=4) or primary metastatic (n=3) solid non-CNS tumors received bevacizumab at 5–10 mg/kg body weight intravenously every 2–3 weeks. Assessment of cardiac function, thyroid hormone levels, urine analysis, and radiographic responses were carried out every 3 months. The median time of bevacizumab treatment was 10 (range, 5–17) months. Patients received a median of 16 (range, 10–38) bevacizumab infusions. With a median follow-up of 25 (range, 13–38) months, five patients relapsed after 7–25 months and three of them died. Two patients are still in complete remission for 31 and 32 months, respectively. Fraction shortening decreased in two patients. Bevacizumab was associated with new-onset increase in basal thyroid-stimulating hormone (n=3), mild proteinuria/hematuria (n=5), intermittent hypertension (n=2), hypertension requiring antihypertensive medication (n=3), and epistaxis (n=2). In two patients, therapy with bevacizumab was terminated because of side effects. Selected patients with relapsed or primary metastatic solid non-CNS tumors of childhood and adolescence might benefit from add-on-therapy with bevacizumab. Although the side effects were usually mild, cardiac monitoring seems to be essential during and after the administration of bevacizumab.

aDepartment of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology

bDepartment of Pediatrics and Adolescent Medicine, Division of Pediatric Cardiology, Medical University of Graz, Graz, Austria

Correspondence to Jasmin Pansy, MD, Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical University of Graz, Auenbruggerplatz 38, A-8036 Graz, Austria Tel: +43 316 385 83676; fax: +43 316 385 13450; e-mail: jasmin.pansy@medunigraz.at

Received July 2, 2012

Accepted October 17, 2012

© 2013 Lippincott Williams & Wilkins, Inc.