title: Patterns of progression in pediatric patients with high-grade glioma or diffuse intrinsic pontine glioma treated with Bevacizumab-based therapy at diagnosis.
abstract: There is a paucity of data regarding patterns of progression in children with high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG) treated with bevacizumab (BVZ) at diagnosis. We performed a retrospective study of 20 children with HGG or DIPG who received BVZ-based therapy at diagnosis on, or according to, a bi-institutional study. Magnetic resonance imaging (MRI) characteristics of first and most recent progressions were reviewed. Comparison was made to a control group of 19 patients who never received BVZ. Imaging definitions of progressive disease (PD) were local: at primary site or within 2 cm, contiguous; diffuse: >2 cm away but contiguous with primary site, ill-defined and infiltrative; distant: new, non-contiguous disease. In the BVZ-treated group, 14 patients had DIPG, six patients had HGG. Median age was 7 years (range: 3-21). Median time to PD and follow-up were 8.8 months (range 4-21) and 11 months (range: 6-25), respectively. Among 14 patients with PD, 8 (57.1 %) had local PD, 6 (42.9 %) had local and diffuse/distant PD, at initial progression. At most recent progression, a median of 10.8 months (range 6-25) from diagnosis, 10 of 14 (71.4 %) had at least diffuse (n = 8), or distant (n = 6) PD. In the comparable control group, 15 patients had PD: 11(73.3 %) local, 4 (26.7 %) local and diffuse/distant PD at first and most recent progressions. Based on these data, we postulate that BVZ may lead to a higher incidence of distant and diffuse disease in newly-diagnosed children with HGG or DIPG who received BVZ-based therapy.
authors.affiliation: Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA, Ralph.salloum@cchmc.org.
authors.forename: Ralph
authors.initials: R
authors.lastname: Salloum
authors.forename: Mariko
authors.initials: M
authors.lastname: DeWire
authors.forename: Adam
authors.initials: A
authors.lastname: Lane
authors.forename: Stewart
authors.initials: S
authors.lastname: Goldman
authors.forename: Trent
authors.initials: T
authors.lastname: Hummel
authors.forename: Lionel
authors.initials: L
authors.lastname: Chow
authors.forename: Lili
authors.initials: L
authors.lastname: Miles
authors.forename: Mary
authors.initials: M
authors.lastname: Sutton
authors.forename: Charles
authors.initials: C
authors.lastname: Stevenson
authors.forename: Maryam
authors.initials: M
authors.lastname: Fouladi
authors.forename: James
authors.initials: J
authors.lastname: Leach
mesh_terms: D000293:Adolescent; D061067:Antibodies, Monoclonal, Humanized / Q000008:administration & dosage*; D000970:Antineoplastic Agents / Q000008:administration & dosage*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000188:drug therapy / Q000473:pathology*; D002166:Camptothecin / Q000008:administration & dosage / Q000031:analogs & derivatives; D059248:Chemoradiotherapy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005910:Glioma / Q000188:drug therapy / Q000473:pathology*; D006801:Humans; D000077146:Irinotecan; D008297:Male; D060787:Neoplasm Grading; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D000970:Antineoplastic Agents; D000068258:Bevacizumab; D000077146:Irinotecan; D002166:Camptothecin