Metastatic Disease of the Nervous System by David Schiff

Author:David Schiff
Language: eng
Format: epub
ISBN: 9780444638793
Publisher: Elsevier Science
Published: 2018-01-04T00:00:00+00:00

Targeted therapy: vascular endothelial growth factor inhibitor

Vascular endothelial growth factor-targeting agents have been used with some success in patients with primary brain tumors but have shown modest activity in BM patients. Besse et al. (2015) conducted a nonrandomized phase II study investigating the efficacy and safety of bevacizumab in chemotherapy-naïve or pretreated patients with NSCLC and asymptomatic untreated BM. Patients with untreated, symptomatic BM received first-line bevacizumab (B) plus carboplatin and paclitaxel (CP) or second-line bevacizumab plus erlotinib (E). The B + CP group had median progression-free survival and median overall survival of 6.7 and 16.0 months, respectively. Overall response rate with B + CP was 62.7%. The B + E group had median progression-free survival and median overall survival of 6.3 and 12 months, respectively, with objective response rate of 12.5%. The trial used Response Evaluation Criteria In Solid Tumors (RECIST 1.0) criteria to assess response and bevacizumab was used in both the groups, therefore it is difficult to predict the effect of bevacizumab in either arm. Moreover, from glioma trials it is clear that bevacizumab can improve progression-free survival without affecting overall survival.

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