贝伐单抗对儿童进展性视路胶质瘤视觉功能、肿瘤大小及毒性的影响：一项全国性回顾性多中心研究

Impact of Bevacizumab on Visual Function, Tumor Size, and Toxicity in Pediatric Progressive Optic Pathway Glioma: A Retrospective Nationwide Multicentre Study.

作者信息

Bennebroek Carlien A M, van Zwol Judith, Porro Giorgio L, Oostenbrink Rianne, Dittrich Anne T M, Groot Annabel L W, Pott Jan W, Janssen Etienne J M, Bauer Noël J, van Genderen Maria M, Saeed Peerooz, Lequin Maarten H, de Graaf Pim, Schouten-van Meeteren Antoinette Y N

机构信息

Department of Ophthalmology, Amsterdam UMC Location University of Amsterdam, 1053 VE Amsterdam, The Netherlands.

Cancer Center Amsterdam, Cancer Treatment and Quality of Life, 1081 HV Amsterdam, The Netherlands.

出版信息

Cancers (Basel). 2022 Dec 10;14(24):6087. doi: 10.3390/cancers14246087.

DOI:10.3390/cancers14246087

PMID:36551572

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9776082/

Abstract

BACKGROUNDS

Bevacizumab (BVZ) is used as a subsequent line of treatment for pediatric optic pathway glioma (OPG) in the case of progression. Data on the treatment effect concerning tumor progression and visual function are scarce and nationwide studies are lacking.

METHODS

We performed a retrospective, nationwide, multicentre cohort study including all pediatric patients with OPG treated with BVZ in the Netherlands (2009-2021). Progression-free survival, change in visual acuity and visual field, MRI-based radiologic response, and toxicity were evaluated.

RESULTS

In total, 33 pediatric patients with OPG were treated with BVZ (median 12 months). Visual acuity improved in 20.5%, remained stable in 74.4%, and decreased in 5.1% of 39 of all analysed eyes. The monocular visual field improved in 73.1%, remained stable in 15.4%, and decreased in 7.7% of 25 analysed eyes. Radiologic response at the end of therapy showed a partial response in 7 patients (21.9%), minor response in 7 (21.9%), stable disease in 15 (46.9%), and progressive disease in 3 (9.3%). Progression-free survival at 18 and 36 months after the start of BVZ reduced from 70.9% to 38.0%. Toxicity (≥grade 3 CTCAE) during treatment was observed in five patients (15.2%).

CONCLUSION

Treatment of BVZ in pediatric patients with OPG revealed stabilisation in the majority of patients, but was followed by progression at a later time point in more than 60% of patients. This profile seems relatively acceptable given the benefits of visual field improvement in more than 70% of analysed eyes and visual acuity improvement in more than 20% of eyes at the cessation of BVZ.

摘要

背景

贝伐单抗（BVZ）在进展情况下用作小儿视路胶质瘤（OPG）的后续治疗方案。关于肿瘤进展和视觉功能的治疗效果数据稀缺，且缺乏全国性研究。

方法

我们进行了一项回顾性、全国性、多中心队列研究，纳入了荷兰所有接受BVZ治疗的小儿OPG患者（2009 - 2021年）。评估了无进展生存期、视力和视野变化、基于MRI的放射学反应以及毒性。

结果

共有33例小儿OPG患者接受了BVZ治疗（中位时间12个月）。在所有分析的39只眼中，20.5%的眼视力改善，74.4%保持稳定，5.1%下降。在25只分析的眼中，73.1%的单眼视野改善，15.4%保持稳定，7.7%下降。治疗结束时的放射学反应显示，7例患者部分缓解（21.9%），7例轻微缓解（21.9%），15例病情稳定（46.9%），3例病情进展（9.3%）。BVZ开始治疗后18个月和36个月的无进展生存率从70.9%降至38.0%。5例患者（15.2%）在治疗期间出现毒性反应（≥3级CTCAE）。