Department of Pediatrics and Adolescent Medicine, Division of Pediatric Hematology and Oncology, Medical University of Graz, Graz, Austria.
Anticancer Drugs. 2013 Feb;24(2):198-203. doi: 10.1097/CAD.0b013e32835b9589.
Bevacizumab is increasingly being used in adult patients with cancer and children with central nervous system (CNS) tumors. Little, however, is known about the efficacy, risks, and benefits of bevacizumab administration in non-CNS tumors of childhood. The aim of the present study was to report on bevacizumab administered as add-on-therapy for poor prognosis non-CNS solid tumors of childhood and adolescence, including a prospective evaluation of side effects of bevacizumab. Seven patients (female: n = 5; median age, 14.5 years) with relapsed (n = 4) or primary metastatic (n = 3) solid non-CNS tumors received bevacizumab at 5-10 mg/kg body weight intravenously every 2-3 weeks. Assessment of cardiac function, thyroid hormone levels, urine analysis, and radiographic responses were carried out every 3 months. The median time of bevacizumab treatment was 10 (range, 5-17) months. Patients received a median of 16 (range, 10-38) bevacizumab infusions. With a median follow-up of 25 (range, 13-38) months, five patients relapsed after 7-25 months and three of them died. Two patients are still in complete remission for 31 and 32 months, respectively. Fraction shortening decreased in two patients. Bevacizumab was associated with new-onset increase in basal thyroid-stimulating hormone (n = 3), mild proteinuria/hematuria (n = 5), intermittent hypertension (n = 2), hypertension requiring antihypertensive medication (n = 3), and epistaxis (n = 2). In two patients, therapy with bevacizumab was terminated because of side effects. Selected patients with relapsed or primary metastatic solid non-CNS tumors of childhood and adolescence might benefit from add-on-therapy with bevacizumab. Although the side effects were usually mild, cardiac monitoring seems to be essential during and after the administration of bevacizumab.
贝伐珠单抗越来越多地用于癌症成人患者和中枢神经系统 (CNS) 肿瘤儿童患者。然而，对于儿童非 CNS 肿瘤中贝伐珠单抗的疗效、风险和益处知之甚少。本研究旨在报告贝伐珠单抗作为添加疗法用于儿童和青少年预后不良的非 CNS 实体瘤，并前瞻性评估贝伐珠单抗的副作用。7 名患者（女性：n = 5；中位年龄 14.5 岁）患有复发（n = 4）或原发性转移性（n = 3）非 CNS 实体肿瘤，接受 5-10mg/kg 体重的贝伐珠单抗静脉注射，每 2-3 周一次。每 3 个月进行心脏功能、甲状腺激素水平、尿液分析和影像学反应评估。贝伐珠单抗治疗的中位时间为 10 个月（范围，5-17 个月）。患者接受了中位数为 16 次（范围，10-38 次）的贝伐珠单抗输注。中位随访时间为 25 个月（范围，13-38 个月），5 名患者在 7-25 个月后复发，其中 3 名死亡。2 名患者分别仍处于完全缓解状态 31 个月和 32 个月。2 名患者的分数缩短。贝伐珠单抗与新发基础促甲状腺激素升高（n = 3）、轻度蛋白尿/血尿（n = 5）、间歇性高血压（n = 2）、需要降压药物治疗的高血压（n = 3）和鼻出血（n = 2）有关。在 2 名患者中，由于副作用，贝伐珠单抗治疗终止。少数患有复发或原发性转移性儿童和青少年非 CNS 实体瘤的患者可能受益于添加贝伐珠单抗治疗。尽管副作用通常较轻，但在使用贝伐珠单抗期间和之后，心脏监测似乎是必不可少的。
