Document Detail

Bevacizumab for progressive vestibular schwannoma in neurofibromatosis type 2: a retrospective review of 31 patients.
MedLine Citation:
PMID:  22805104     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: Early studies suggest that bevacizumab treatment can result in tumor shrinkage and hearing improvement for some patients with neurofibromatosis type 2 (NF2). The aim of this study was to report extended follow-up in a larger cohort of similarly treated patients.
STUDY DESIGN: Retrospective study.
SETTING: Tertiary referral center
PATIENTS: Thirty-one consecutive NF2 patients who received bevacizumab for progressive vestibular schwannomas.
MAIN OUTCOME MEASURE: Hearing improvement, defined as an improvement in word recognition score above the 95% critical difference compared with baseline, and radiographic response, defined as a 20% or greater decrease in tumor volume compared with baseline.
RESULTS: The median age was 26 years (range, 12-73 yr). The median volumetric tumor growth rate before treatment was 64% per year. At the time of analysis, the median duration of treatment was 14 months (range, 6-41 mo) with a total of 47 patient-years of follow-up. A hearing response occurred in 57% (13/23) of evaluable patients and a radiographic response in 55% (17/31) of target vestibular schwannomas. The median time to response was 3 months for both end points. The only clinical or radiographic feature at baseline that correlated with change in tumor volume at 3 months was the mean apparent diffusion coefficient value, a radiologic marker of edema (p = 0.036). Ninety percent of patients had stable or improved hearing after 1 year of treatment and 61% at 3 years; 88% of patients had stable or decreased tumor size after 1 year of treatment and 54% at 3 years. Overall, treatment was well tolerated.
CONCLUSION: Bevacizumab treatment was followed by hearing improvement and tumor shrinkage in more than 50% of progressive vestibular schwannomas in NF2 patients. Stable or improved hearing was retained in the majority of patients.
Scott R Plotkin; Vanessa L Merker; Chris Halpin; Dominique Jennings; Michael J McKenna; Gordon J Harris; Fred G Barker
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  33     ISSN:  1537-4505     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-07-18     Completed Date:  2012-12-03     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1046-52     Citation Subset:  IM    
Department of Neurology and Cancer Center, Massachusetts General Hospital, Boston 02114, USA.
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MeSH Terms
Angiogenesis Inhibitors / adverse effects,  therapeutic use*
Antibodies, Monoclonal, Humanized / adverse effects,  therapeutic use*
Audiometry, Pure-Tone
Disease Progression
Follow-Up Studies
Hearing Loss / etiology,  prevention & control
Magnetic Resonance Imaging
Middle Aged
Neurofibromatosis 2 / complications*
Neuroma, Acoustic / drug therapy*,  etiology*
Retrospective Studies
Treatment Outcome
Vascular Endothelial Growth Factor A / antagonists & inhibitors
Young Adult
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 0/Vascular Endothelial Growth Factor A; 2S9ZZM9Q9V/bevacizumab

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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