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Bevacizumab therapy for adults with recurrent/progressive meningioma: a retrospective series

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Abstract

Intracranial meningiomas are often indolent tumors which typically grow over years to decades. Nonetheless, meningiomas that progress after maximum safe resection and radiation therapy pose a significant therapeutic challenge and effective therapies have yet to be identified. Preclinical studies implicate angiogenesis in the pathophysiology of more aggressive meningiomas, suggesting that anti-angiogenic therapies may be of utility in this setting. We performed a retrospective review of fourteen patients with recurrent meningioma treated at Duke University Medical Center with bevacizumab, a humanized monoclonal antibody against vascular endothelial growth factor, administered either alone or in combination with chemotherapy. Most patients were heavily pre-treated. Progression-free survival at 6 months was 86 % and was comparable regardless of meningioma grade and whether bevacizumab was administered as monotherapy or in combination with chemotherapy. Most toxicities were mild however single patients developed CNS hemorrhage (grade 1) and intestinal perforation (grade 4), respectively. Bevacizumab can be administered safely to patients with meningioma and appears to be associated with encouraging anti-tumor effect when administered as either a single agent or in combination with chemotherapy. Phase II trials investigating bevacizumab in patients with progressive/recurrent meningioma are warranted.

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Acknowledgments

This work was supported by NIH Grants 5P50-NS-20023 and 5 R37 CA11898; NIH Grant MO1 RR 30, GCRC Program, NCRR; and NCI SPORE 1 P20 CA096890; and a grant from Genentech Pharmaceuticals.

The authors thank Wendy Gentry for her excellent secretarial support in the development of this manuscript.

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Author notes

  1. Emil Lou

    Present address: Department of Medicine, Division of Hematology, Oncology and Transplantation, University of Minnesota, Minneapolis, MN, 55455, USA

Authors and Affiliations

  1. Department of Surgery, The Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, 27710, USA

    Emil Lou, Ashley L. Sumrall, Scott Turner, Julie Norfleet, Henry S. Friedman & David A. Reardon

  2. Departments of Medicine, The Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, 27710, USA

    Katherine B. Peters, Annick Desjardins & James J. Vredenburgh

  3. Department of Pathology, The Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, 27710, USA

    Roger E. McLendon

  4. Cancer Center Biostatistics, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, NC, 27710, USA

    James E. Herndon II & Frances McSherry

  5. Department of Pediatrics, The Preston Robert Tisch Brain Tumor Center at Duke, Duke University Medical Center, Durham, NC, 27710, USA

    Henry S. Friedman & David A. Reardon

  6. Center for Neuro-Oncology, Dana-Farber Cancer Institute, 450 Brookline Avenue, SW-460G, Boston, MA, 02215, USA

    David A. Reardon

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Correspondence to David A. Reardon.

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Lou, E., Sumrall, A.L., Turner, S. et al. Bevacizumab therapy for adults with recurrent/progressive meningioma: a retrospective series. J Neurooncol 109, 63–70 (2012). https://doi.org/10.1007/s11060-012-0861-0

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