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Dural venous sinus thrombosis in anaplastic astrocytoma following concurrent temozolomide and focal brain radiotherapy plus bevacizumab

Journal of Neuro-Oncology volume 104, pages 595–598 (2011)Cite this article

Abstract

Malignant gliomas have long been a therapeutic dilemma in neuro-oncology, with a poor overall prognosis. Standard treatment, consisting of primary resection, followed by radiation therapy and temozolomide, has improved prognosis. Recently, studies have looked at the addition of bevacizumab (Avastin), a humanized murine IgG1 monoclonal antibody against vascular endothelial growth factor-A, to conventional regiments. Bevacizumab gained US FDA approval for single agent use in recurrent glioblastoma in 2009. Known side effects of bevacizumab include increased risk of arterial and venous thromboembolism, as well as hemorrhage. With emerging data for the use of bevacizumab in malignant gliomas, the extent of risks such as bleeding and thrombosis in patients with primary brain tumors treated with bevacizumab remains unknown. Here, we present only the second reported case of dural venous sinus thrombosis during treatment with bevacizumab and the first reported case for a primary glioma treated with temozolomide, radiation, and bevacizumab.

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Authors and Affiliations

  1. West Virginia University School of Medicine, Morgantown, WV, 26506, USA

    J. A. Vargo, B. M. Snelling & E. R. Ghareeb

  2. Department of Neurology, West Virginia University School of Medicine, Charleston, WV, 25304, USA

    K. John

  3. Department of Hematology and Oncology, West Virginia University School of Medicine, Charleston, WV, 25304, USA

    J. N. Frame

  4. David Lee Cancer Center, Charleston Area Medical Center, Charleston, WV, 25304, USA

    J. N. Frame

  5. Department of Neurosurgery, West Virginia University School of Medicine, Charleston, WV, 25304, USA

    J. H. Schmidt

  6. Department of Medicine, Division of Neurology, Duke University School of Medicine, Durham, NC, 27710, USA

    K. B. Peters

  7. 1421 Stonehenge Rd, Charleston, WV, 25314, USA

    J. A. Vargo

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  1. J. A. Vargo
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  2. B. M. Snelling
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  3. E. R. Ghareeb
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  4. K. John
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  5. J. N. Frame
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  7. K. B. Peters
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Correspondence to J. A. Vargo.

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Vargo, J.A., Snelling, B.M., Ghareeb, E.R. et al. Dural venous sinus thrombosis in anaplastic astrocytoma following concurrent temozolomide and focal brain radiotherapy plus bevacizumab. J Neurooncol 104, 595–598 (2011). https://doi.org/10.1007/s11060-010-0519-8

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  • DOI: https://doi.org/10.1007/s11060-010-0519-8

Keywords

  • Dural sinus vein thrombosis
  • Bevacizumab
  • Anaplastic astrocytoma
  • Venous thromboembolism