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Effect of bevacizumab on intracranial meningiomas in patients with neurofibromatosis type 2 - a retrospective case series

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@article{f1c35c17d62d48de92f90f0e7e1238ce,
title = "Effect of bevacizumab on intracranial meningiomas in patients with neurofibromatosis type 2 - a retrospective case series",
abstract = "PURPOSE: The hallmark of neurofibromatosis type 2 (NF2) is bilateral vestibular schwannomas (VS). Approximately 80{\%} of NF2 patients also have intracranial meningiomas. Vascular endothelial growth factor (VEGF) is expressed in both NF2-related and sporadic occurring meningiomas and anti-VEGF therapy (bevacizumab) may, therefore, be beneficial in NF2-related meningiomas. The purpose of the study was to report the effect of bevacizumab on meningiomas in NF2 patients.MATERIALS AND METHODS: We retrospectively reviewed the effect of bevacizumab on the cross-sectional area (CSA) of 14 intracranial meningiomas in 7 NF2 patients. Bevacizumab 10 mg/kg was administered intravenously every two weeks for six months and 15 mg/kg every three weeks thereafter. Patients were evaluated according to the modified Macdonald criteria with repeated magnetic resonance (MR) scans.RESULTS: The median duration of therapy was 27 months (range 16-34) and 42 MR scans (median 8, range 4-11) were reviewed. The median annual change in meningioma CSA prior to bevacizumab was 2{\%} (range -4{\%}-+76{\%}). During treatment, a decrease in meningioma CSA was observed in 5 of 14 meningiomas (36{\%}) in 5 of 7 patients (71{\%}). The median decrease in CSA was -10{\%} (range -3{\%}--25{\%}). One meningioma (7{\%}) progressed and the remaining (93{\%}) had stable disease.CONCLUSIONS: Bevacizumab may slow or reverse the growth of some NF-related meningiomas. However, we have previously reported a fatal case of intracerebral hemorrhage following bevacizumab in NF2 patients, wherefore, this effect needs to be balanced carefully against the risk of side effects.",
author = "Alanin, {Mikkel Christian} and Camilla Klausen and Per Caye-Thomasen and Carsten Thomsen and Kaare Fugleholm and Lars Poulsgaard and Ulrik Lassen and Mau-S{\o}rensen, {Poul Morten} and Hofland, {Kenneth Francis}",
year = "2016",
doi = "10.3109/00207454.2015.1092443",
language = "English",
volume = "126",
pages = "1002--6",
journal = "International Journal of Neuroscience",
issn = "0020-7454",
publisher = "Informa Healthcare",
number = "11",

}

RIS

TY - JOUR

T1 - Effect of bevacizumab on intracranial meningiomas in patients with neurofibromatosis type 2 - a retrospective case series

AU - Alanin, Mikkel Christian

AU - Klausen, Camilla

AU - Caye-Thomasen, Per

AU - Thomsen, Carsten

AU - Fugleholm, Kaare

AU - Poulsgaard, Lars

AU - Lassen, Ulrik

AU - Mau-Sørensen, Poul Morten

AU - Hofland, Kenneth Francis

PY - 2016

Y1 - 2016

N2 - PURPOSE: The hallmark of neurofibromatosis type 2 (NF2) is bilateral vestibular schwannomas (VS). Approximately 80% of NF2 patients also have intracranial meningiomas. Vascular endothelial growth factor (VEGF) is expressed in both NF2-related and sporadic occurring meningiomas and anti-VEGF therapy (bevacizumab) may, therefore, be beneficial in NF2-related meningiomas. The purpose of the study was to report the effect of bevacizumab on meningiomas in NF2 patients.MATERIALS AND METHODS: We retrospectively reviewed the effect of bevacizumab on the cross-sectional area (CSA) of 14 intracranial meningiomas in 7 NF2 patients. Bevacizumab 10 mg/kg was administered intravenously every two weeks for six months and 15 mg/kg every three weeks thereafter. Patients were evaluated according to the modified Macdonald criteria with repeated magnetic resonance (MR) scans.RESULTS: The median duration of therapy was 27 months (range 16-34) and 42 MR scans (median 8, range 4-11) were reviewed. The median annual change in meningioma CSA prior to bevacizumab was 2% (range -4%-+76%). During treatment, a decrease in meningioma CSA was observed in 5 of 14 meningiomas (36%) in 5 of 7 patients (71%). The median decrease in CSA was -10% (range -3%--25%). One meningioma (7%) progressed and the remaining (93%) had stable disease.CONCLUSIONS: Bevacizumab may slow or reverse the growth of some NF-related meningiomas. However, we have previously reported a fatal case of intracerebral hemorrhage following bevacizumab in NF2 patients, wherefore, this effect needs to be balanced carefully against the risk of side effects.

AB - PURPOSE: The hallmark of neurofibromatosis type 2 (NF2) is bilateral vestibular schwannomas (VS). Approximately 80% of NF2 patients also have intracranial meningiomas. Vascular endothelial growth factor (VEGF) is expressed in both NF2-related and sporadic occurring meningiomas and anti-VEGF therapy (bevacizumab) may, therefore, be beneficial in NF2-related meningiomas. The purpose of the study was to report the effect of bevacizumab on meningiomas in NF2 patients.MATERIALS AND METHODS: We retrospectively reviewed the effect of bevacizumab on the cross-sectional area (CSA) of 14 intracranial meningiomas in 7 NF2 patients. Bevacizumab 10 mg/kg was administered intravenously every two weeks for six months and 15 mg/kg every three weeks thereafter. Patients were evaluated according to the modified Macdonald criteria with repeated magnetic resonance (MR) scans.RESULTS: The median duration of therapy was 27 months (range 16-34) and 42 MR scans (median 8, range 4-11) were reviewed. The median annual change in meningioma CSA prior to bevacizumab was 2% (range -4%-+76%). During treatment, a decrease in meningioma CSA was observed in 5 of 14 meningiomas (36%) in 5 of 7 patients (71%). The median decrease in CSA was -10% (range -3%--25%). One meningioma (7%) progressed and the remaining (93%) had stable disease.CONCLUSIONS: Bevacizumab may slow or reverse the growth of some NF-related meningiomas. However, we have previously reported a fatal case of intracerebral hemorrhage following bevacizumab in NF2 patients, wherefore, this effect needs to be balanced carefully against the risk of side effects.

U2 - 10.3109/00207454.2015.1092443

DO - 10.3109/00207454.2015.1092443

M3 - Journal article

VL - 126

SP - 1002

EP - 1006

JO - International Journal of Neuroscience

JF - International Journal of Neuroscience

SN - 0020-7454

IS - 11

ER -

ID: 45966257