title: Reduced dosage of bevacizumab in treatment of vestibular schwannomas in patients with neurofibromatosis type 2.
abstract: Neurofibromatosis type 2 (NF2) is a tumor suppressor syndrome associated with vestibular schwannomas and other benign tumors of the central nervous system. Bevacizumab is used for treatment of progressive vestibular schwannomas, with the intent to reduce tumor size or preserve/improve hearing. Prolonged treatment can cause side effects such as hypertension and proteinuria, which can be cause for discontinuation of therapy. We report on 3 patients who were treated with bevacizumab for 66-76 months, with dose reductions that minimized side effects while sustaining the clinical effect of the antiangiogenic therapy. After dose reduction from 5 mg/kg bi- or tri-weekly to 2.5 mg bi- or tri-weekly, all patients appeared clinically stable and radiographic and audiologic follow-up showed sustained response. In conclusion, in some NF2 patients, dose reduction of bevacizumab seems to be an effective option for managing side effects.
authors: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany. s.farschtschi@uke.de.
authors: Said
authors: S
authors: Farschtschi
authors: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors: Philipp
authors: P
authors: Kollmann
authors: Department of Otorhinolaryngology and Head and Neck Surgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors: Carsten
authors: C
authors: Dalchow
authors: Department of Internal Medicine II and Clinic (Oncology Center), University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors: Alexander
authors: A
authors: Stein
authors: Department of Neurology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
authors: Victor-Felix
authors: VF
authors: Mautner
mesh_terms: D000328:Adult; D020533:Angiogenesis Inhibitors / Q000008:administration & dosage*; D000068258:Bevacizumab / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D034381:Hearing Loss / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D016518:Neurofibromatosis 2 / Q000150:complications*; D009464:Neuroma, Acoustic / Q000188:drug therapy*
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
keywords: Bevacizumab; Dose reduction; NF2; Neurofibromatosis; VEGF; Vestibular schwannoma