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Rebound tumour progression after the cessation of bevacizumab therapy in patients with recurrent high-grade glioma

  • Clinical Study - Patient Study
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Abstract

After withdrawal of bevacizumab in patients with recurrent high-grade glioma, we have observed a rapid tumour re-growth or “rebound” radiographic phenomenon with accelerated clinical decline. We retrospectively reviewed 11 patients treated at the Henry Ford Hermelin Brain Tumor Center with recurrent high-grade glioma who demonstrated a rebound progression pattern after the discontinuation of bevacizumab. The original tumour area-of-enhancement increased by a mean of 158%, when compared to the rebound magnetic resonance imaging. After rebound, no patients (0/8) showed a response to next-line treatments that did not include bevacizumab. The median survival of those re-treated with bevacizumab was 149 and 32 days for those who received other regimens. Abrupt discontinuation of bevacizumab after recurrence often leads to a dramatic rebound phenomenon and rapid clinical decline. Slow tapering of the bevacizumab dose after tumour progression may prevent this from occurring and improve responsiveness to next-line therapies.

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Authors and Affiliations

  1. Henry Ford Health System, Hermelin Brain Tumor Center, 2799 W Grand Blvd, Detroit, MI, 48202, USA

    Richard M. Zuniga, Roy Torcuator & Tom Mikkelsen

  2. Department of Neurosurgery, Henry Ford Health System, Detroit, MI, USA

    Roy Torcuator & Tom Mikkelsen

  3. Department of Neuroradiology, Henry Ford Health System, Detroit, MI, USA

    Rajan Jain

  4. Department of Medical Oncology, Henry Ford Health System, Detroit, MI, USA

    John Anderson & Thomas Doyle

  5. Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, MI, USA

    Lonni Schultz

Authors
  1. Richard M. Zuniga
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  2. Roy Torcuator
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  3. Rajan Jain
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  4. John Anderson
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  5. Thomas Doyle
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  6. Lonni Schultz
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  7. Tom Mikkelsen
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Correspondence to Richard M. Zuniga.

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Zuniga, R.M., Torcuator, R., Jain, R. et al. Rebound tumour progression after the cessation of bevacizumab therapy in patients with recurrent high-grade glioma. J Neurooncol 99, 237–242 (2010). https://doi.org/10.1007/s11060-010-0121-0

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  • DOI: https://doi.org/10.1007/s11060-010-0121-0

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