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Eight-year survival of a recurrent glioblastoma patient treated with molecularly tailored therapy: a case report

  • Quintino Giorgio D’Alessandris
  • Nicola Montano
  • Maurizio Martini
  • Tonia Cenci
  • Liverana Lauretti
  • Vittorio Stumpo
  • Fabrizio Pignotti
  • Alessandro Olivi
  • Eduardo Fernandez
  • Luigi Maria Larocca
  • Roberto Pallini
Case Report - Tumor - Glioma
Part of the following topical collections:
  1. Tumor – Glioma

Abstract

Treatment options for recurrent glioblastoma are scarce; targeted therapy trials were disappointing, probably due to enrollment of patients without molecular selection. We treated with bevacizumab and erlotinib a 66-year-old male suffering from recurrent glioblastoma, IDH-wildtype and MGMT unmethylated, after three neurosurgeries. Treatment was tailored on molecular profile of recurrent tumor—namely, EGFRvIII positivity, VEGF overexpression, normal PTEN, low total VEGF and VEGF-121 mRNA—and resulted in complete, exceptionally durable response (51-month progression-free survival). Notably, histology of further recurrence after therapy was reminiscent of sarcoma. We suggest a thorough molecular screening for personalization of targeted therapy in recurrent glioblastoma.

Keywords

Glioblastoma Targeted therapy Tailored therapy Bevacizumab Erlotinib 

Abbreviations

EGFR

Epidermal growth factor receptor

GBM

Glioblastoma

MR

Magnetic resonance

OS

Overall survival

PFS

Progression-free survival

VEGF

Vascular endothelial growth factor

Notes

Acknowledgements

The authors thank the Head Nurse, Giovanna Farisei, and all the nurses of the Department of Neurosurgery of Fondazione Policlinico Universitario A. Gemelli IRCCS for their invaluable work in giving care to GBM patients.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Copyright information

© Springer-Verlag GmbH Austria, part of Springer Nature 2018

Authors and Affiliations

  • Quintino Giorgio D’Alessandris
    • 1
  • Nicola Montano
    • 1
  • Maurizio Martini
    • 2
    • 3
  • Tonia Cenci
    • 2
  • Liverana Lauretti
    • 1
    • 3
  • Vittorio Stumpo
    • 3
  • Fabrizio Pignotti
    • 1
    • 3
  • Alessandro Olivi
    • 1
    • 3
  • Eduardo Fernandez
    • 1
    • 3
  • Luigi Maria Larocca
    • 2
    • 3
  • Roberto Pallini
    • 1
    • 3
  1. 1.Department of NeurosurgeryFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
  2. 2.Department of PathologyFondazione Policlinico Universitario Agostino Gemelli IRCCSRomeItaly
  3. 3.Università Cattolica del Sacro CuoreRomeItaly

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