title: Bevacizumab for critical brain metastases in a patient with pulmonary pleomorphic carcinoma.
abstract: Bevacizumab was initially contraindicated in patients with brain metastases, but several reports have shown the efficacy and safety of bevacizumab for brain metastases. We herein report the case of a patient with pulmonary pleomorphic carcinoma for which bevacizumab plus weekly paclitaxel following whole-brain radiotherapy (WBRT) was effectively and safely administered for critical and refractory brain metastases. Although the 50-year-old male patient received WBRT with anti-edema therapies for progressive brain metastases, his clinical symptoms deteriorated rapidly. After the completion of WBRT, we administered bevacizumab plus weekly paclitaxel, and his neurological symptoms improved dramatically. Brain magnetic resonance imaging demonstrated a marked response by the brain metastases and improved brain edema. This case suggested both synergism between WBRT and bevacizumab, and an anti-edema effect of bevacizumab. Bevacizumab may be therefore a potent therapeutic option for patients with refractory brain metastases.
authors.affiliation: Division of Integrated Oncology, Institute of Biomedical Research and Innovation, Japan.
authors.forename: Akito
authors.initials: A
authors.lastname: Hata
authors.forename: Shiro
authors.initials: S
authors.lastname: Fujita
authors.forename: Kenji
authors.initials: K
authors.lastname: Takayama
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Katakami
mesh_terms: D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000972:Antineoplastic Agents, Phytogenic / Q000008:administration & dosage*; D000068258:Bevacizumab; D001929:Brain Edema / Q000188:drug therapy / Q000209:etiology / Q000532:radiotherapy; D001932:Brain Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary*; D002277:Carcinoma / Q000188:drug therapy* / Q000532:radiotherapy / Q000556:secondary*; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017239:Paclitaxel / Q000008:administration & dosage; D016896:Treatment Outcome
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000972:Antineoplastic Agents, Phytogenic; D000068258:Bevacizumab; D017239:Paclitaxel