title: Bevacizumab in Combination with Chemotherapy for Colorectal Brain Metastasis.
abstract: BACKGROUND
  Brain metastases are rare in patients with colorectal cancer, but the incidence is expected to rise due to prolonged survival resulting from more effective regimens including anti-EGF-receptor and anti-angiogenic antibodies. Because of the potential fear of intracranial hemorrhage, patients with colorectal brain metastases have been excluded from clinical trials involving bevacizumab or aflibercept.
  
  
  METHODS
  Five patients with colorectal brain metastases treated with bevacizumab-containing chemotherapy regimen following either neurosurgery, radiosurgery, or whole-brain radiotherapy were identified between 2009 and 2014. The clinicopathological data and outcomes for these patients were reviewed.
  
  
  RESULTS
  Mean time to disease progression concerning brain metastases was 14.8 months (range 5-25). Overall survival was 26.2 months (range 7-42 months) and overall survival since diagnosis of brain metastases was 20.6 month (7-42). Best response was a partial response in two and a stable disease in three patients. Treatment-related adverse events were mild hypertension (grade 1), diarrhea (grade 1), and fatigue (grade 1). No intracranial hemorrhage was observed.
  
  
  CONCLUSIONS
  Bevacizumab in combination with chemotherapy is a feasible option for palliative treatment of patients with colorectal brain metastasis with a good safety profile.
authors.affiliation: Medizinische Klinik 1, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany. fabian.finkelmeier@kgu.de.
authors.forename: Fabian
authors.initials: F
authors.lastname: Finkelmeier
authors.affiliation: Institut für Neuroradiologie, Universitätsklinikum Frankfurt, Goethe-Universität, Schleusenweg 2-16, 60528, Frankfurt/Main, Germany.
authors.forename: Se-Jong
authors.initials: SJ
authors.lastname: You
authors.affiliation: Medizinische Klinik 1, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Waidmann
authors.affiliation: Gamma Knife Zentrum Frankfurt, Schleusenweg 2-16, 60528, Frankfurt am Main, Germany.
authors.forename: Robert
authors.initials: R
authors.lastname: Wolff
authors.affiliation: Medizinische Klinik 1, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Zeuzem
authors.affiliation: Dr. Senckenbergisches Institut für Neuroonkologie, Universitätsklinikum Frankfurt, Goethe-Universität, Schleusenweg 2-16, 60528, Frankfurt/Main, Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Bähr
authors.affiliation: Medizinische Klinik 1, Universitätsklinikum Frankfurt, Goethe-Universität, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
authors.forename: Jörg
authors.initials: J
authors.lastname: Trojan
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy* / Q000556:secondary; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D001932:Brain Neoplasms / Q000188:drug therapy* / Q000556:secondary; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab
keywords: Bevacizumab; Brain metastasis; Colorectal carcinoma