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Patterns of progression in pediatric patients with high-grade glioma or diffuse intrinsic pontine glioma treated with Bevacizumab-based therapy at diagnosis

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Abstract

There is a paucity of data regarding patterns of progression in children with high-grade glioma (HGG) or diffuse intrinsic pontine glioma (DIPG) treated with bevacizumab (BVZ) at diagnosis. We performed a retrospective study of 20 children with HGG or DIPG who received BVZ-based therapy at diagnosis on, or according to, a bi-institutional study. Magnetic resonance imaging (MRI) characteristics of first and most recent progressions were reviewed. Comparison was made to a control group of 19 patients who never received BVZ. Imaging definitions of progressive disease (PD) were local: at primary site or within 2 cm, contiguous; diffuse: >2 cm away but contiguous with primary site, ill-defined and infiltrative; distant: new, non-contiguous disease. In the BVZ-treated group, 14 patients had DIPG, six patients had HGG. Median age was 7 years (range: 3–21). Median time to PD and follow-up were 8.8 months (range 4–21) and 11 months (range: 6–25), respectively. Among 14 patients with PD, 8 (57.1 %) had local PD, 6 (42.9 %) had local and diffuse/distant PD, at initial progression. At most recent progression, a median of 10.8 months (range 6-25) from diagnosis, 10 of 14 (71.4 %) had at least diffuse (n = 8), or distant (n = 6) PD. In the comparable control group, 15 patients had PD: 11(73.3 %) local, 4 (26.7 %) local and diffuse/distant PD at first and most recent progressions. Based on these data, we postulate that BVZ may lead to a higher incidence of distant and diffuse disease in newly-diagnosed children with HGG or DIPG who received BVZ-based therapy.

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Authors and Affiliations

  1. Division of Oncology, Cancer and Blood Diseases Institute, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH, 45229, USA

    Ralph Salloum, Mariko DeWire, Adam Lane, Trent Hummel, Lionel Chow & Maryam Fouladi

  2. Division of Hematology, Oncology, and Stem Cell Transplant, Ann & Robert H. Lurie Children’s Hospital of Chicago, Chicago, IL, USA

    Stewart Goldman

  3. Division of Pathology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Lili Miles

  4. Division of Neurology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Mary Sutton

  5. Division of Neurosurgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Charles Stevenson

  6. Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    James Leach

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  1. Ralph Salloum
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  2. Mariko DeWire
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Correspondence to Ralph Salloum.

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Salloum, R., DeWire, M., Lane, A. et al. Patterns of progression in pediatric patients with high-grade glioma or diffuse intrinsic pontine glioma treated with Bevacizumab-based therapy at diagnosis. J Neurooncol 121, 591–598 (2015). https://doi.org/10.1007/s11060-014-1671-3

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