Neuro-Oncology: Temozolomide or bevacizumab for spinal cord high-grade gliomas

Monday, June 11, 2012

Temozolomide or bevacizumab for spinal cord high-grade gliomas

Abstract

High-grade gliomas of the spinal cord are rare tumors, traditionally managed with surgery and radiotherapy. Once patients fail standard treatment, many receive some chemotherapy, although the data supporting such is limited. We reviewed our experience treating high-grade gliomas of the spinal cord with standard intracranial regimens including temozolomide and bevacizumab. Outcomes investigated include radiographic response, clinical response, progression-free survival, and overall survival. We identified eight patients who were treated with temozolomide and six who were treated with bevacizumab. Temozolomide was administered to three patients at initial diagnosis and five patients at recurrence after failing prior radiotherapy. For the recurrent patients, the median time-to-progression was 6.6 months (range 1–40 months) and the median overall survival from initiation of temozolomide was 16.6 months (range 1.2–64.5 months). We identified six patients who received bevacizumab at the time of recurrence. MRI demonstrated a partial response in five patients which also correlated with clinical improvement. The median time to progression was 20.7 months (range 3.3–29.9 months) and median overall survival was 22.8 months (range 3.3–31.8 months). This retrospective review suggests that temozolomide and bevacizumab may be beneficial in spinal cord high-grade gliomas. The compact architecture of the spinal cord makes bevacizumab a particularly appealing agent due to the drug's effect on peritumoral edema and mass effect.

Content Type Journal Article
Category Clinical Study
Pages 1-5
DOI 10.1007/s11060-012-0905-5
Authors
- Thomas J. Kaley, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
- Ijah Mondesire-Crump, Department of Surgery, St Luke's-Roosevelt Hospital, New York, NY, USA
- Igor T. Gavrilovic, Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA