TY  - JOUR
A1  - Burger, Michael Christian
A1  - Mildenberger, Iris C.
A1  - Wagner, Marlies
A1  - Mittelbronn, Michel Guy André
A1  - Steinbach, Joachim Peter
A1  - Bähr, Oliver
T1  - Bevacizumab for patients with recurrent gliomas presenting with a gliomatosis cerebri growth pattern
T2  - International journal of molecular sciences
N2  - Bevacizumab has been shown to improve progression-free survival and neurologic function, but failed to improve overall survival in newly diagnosed glioblastoma and at first recurrence. Nonetheless, bevacizumab is widely used in patients with recurrent glioma. However, its use in patients with gliomas showing a gliomatosis cerebri growth pattern is contentious. Due to the marked diffuse and infiltrative growth with less angiogenic tumor growth, it may appear questionable whether bevacizumab can have a therapeutic effect in those patients. However, the development of nodular, necrotic, and/or contrast-enhancing lesions in patients with a gliomatosis cerebri growth pattern is not uncommon and may indicate focal neo-angiogenesis. Therefore, control of growth of these lesions as well as control of edema and reduction of steroid use may be regarded as rationales for the use of bevacizumab in these patients. In this retrospective patient series, we report on 17 patients with primary brain tumors displaying a gliomatosis cerebri growth pattern (including seven glioblastomas, two anaplastic astrocytomas, one anaplastic oligodendroglioma, and seven diffuse astrocytomas). Patients have been treated with bevacizumab alone or in combination with lomustine or irinotecan. Seventeen matched patients treated with bevacizumab for gliomas with a classical growth pattern served as a control cohort. Response rate, progression-free survival, and overall survival were similar in both groups. Based on these results, anti-angiogenic therapy with bevacizumab should also be considered in patients suffering from gliomas with a mainly infiltrative phenotype.
KW  - primary brain tumors
KW  - glioma
KW  - glioblastoma
KW  - gliomatosis cerebri growth pattern
KW  - anti-angiogenic therapy
KW  - bevacizumab
Y1  - 2017
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/44255
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-442558
SN  - 1422-0067
SN  - 1661-6596
N1  - © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
VL  - 18
IS  - 4, Art. 726
SP  - 1
EP  - 10
PB  - Molecular Diversity Preservation International
CY  - Basel
ER  -