title: Activity of temozolomide and bevacizumab in the treatment of locally advanced, recurrent, and metastatic hemangiopericytoma and malignant solitary fibrous tumor.
abstract: BACKGROUND
  Hemangiopericytomas and malignant solitary fibrous tumors (HPC/SFT) are rare, closely related sarcomas with unpredictable behavior that respond infrequently to chemotherapy. An optimal systemic treatment strategy for advanced HPC/SFT has not yet been identified.
  
  
  METHODS
  We retrospectively analyzed the records of 14 patients with histopathologically confirmed HPC/SFT who were treated at The University of Texas MD Anderson Cancer Center between May 2005 and June 2007. All patients were treated with temozolomide 150 mg/m(2) orally on days 1-7 and days 15-21 and bevacizumab 5 mg/kg intravenously on days 8 and 22, repeated at 28-day intervals. Computed tomography assessment of tumor size and density (Choi criteria) was used to determine the best response to therapy. The Kaplan-Meier method was used to estimate progression-free survival.
  
  
  RESULTS
  The median follow-up period was 34 months. Eleven patients (79%) achieved a Choi partial response, with a median time to response of 2.5 months. Two patients (14%) had stable disease as the best response, and 1 patient (7%) had Choi progressive disease as the best response. The estimated median progression-free survival was 9.7 months, with a 6-month progression-free rate of 78.6%. The most frequently observed toxic effect was myelosuppression.
  
  
  CONCLUSIONS
  Combination therapy with temozolomide and bevacizumab is a generally well-tolerated and clinically beneficial regimen for HPC/SFT patients. Additional investigation in a controlled, prospective trial is warranted.
authors.affiliation: Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas 77230-1402, USA. mpark@mdanderson.org
authors.forename: Min S
authors.initials: MS
authors.lastname: Park
authors.forename: Shreyaskumar R
authors.initials: SR
authors.lastname: Patel
authors.forename: Joseph A
authors.initials: JA
authors.lastname: Ludwig
authors.forename: Jonathan C
authors.initials: JC
authors.lastname: Trent
authors.forename: Charles A
authors.initials: CA
authors.lastname: Conrad
authors.forename: Alexander J
authors.initials: AJ
authors.lastname: Lazar
authors.forename: Wei-Lien
authors.initials: WL
authors.lastname: Wang
authors.forename: Piyaporn
authors.initials: P
authors.lastname: Boonsirikamchai
authors.forename: Haesun
authors.initials: H
authors.lastname: Choi
authors.forename: Xuemei
authors.initials: X
authors.lastname: Wang
authors.forename: Robert S
authors.initials: RS
authors.lastname: Benjamin
authors.forename: Dejka M
authors.initials: DM
authors.lastname: Araujo
mesh_terms: D000328:Adult; D000368:Aged; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D000068258:Bevacizumab; D003606:Dacarbazine / Q000008:administration & dosage / Q000031:analogs & derivatives*; D005260:Female; D006393:Hemangiopericytoma / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D054364:Solitary Fibrous Tumors / Q000188:drug therapy*; D000077204:Temozolomide; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D003606:Dacarbazine; D000077204:Temozolomide