2009 ASCO Annual Meeting Abstract No: 2060 Citation: J Clin Oncol 27:15s, 2009 (suppl; abstr 2060)
R. M. Green, T. Cloughesy, R. Stupp, L. M. DeAngelis, E. A. Woyshner, D. E. Ney, A. B. Lassman; Kaiser Foundation Hospital, Los Angeles, CA; University of California, Los Angeles, Los Angeles, CA; University of Lausanne Hospitals, Lausanne, Switzerland; Memorial Sloan-Kettering Cancer Center, New York, NY
Background: Ependymoma is a rare type of glioma, representing less than 5% of brain tumors in adults. Radiotherapy (RT) is commonly administered, but there is no standard chemotherapy. At recurrence ependymoma is notoriously refractory to therapy and the prognosis is poor. In recurrent glioblastoma, encouraging responses with bevacizumab have been observed. Therefore, we treated patients with recurrent ependymoma and anaplastic ependymoma with bevacizumab containing chemotherapy regimens.
Methods: We retrospectively identified adults treated for recurrent ependymoma and anaplastic ependymoma with bevacizumab containing chemotherapy regimens. We determined radiographic response (Macdonald criteria) and estimated median time to progression (TTP) and overall survival (OS) by the Kaplan-Meier method.
Results: There were six patients, four women and two men, with a median age of 29 years (range, 20-65). Prior treatment included RT in all and temozolomide in four. Bevacizumab (5-10 mg/kg) every other week was combined with cytotoxic agents: irinotecan (3), carboplatin (2), or temozolomide (1). Five patients achieved a partial response (83%); in one patient the disease was stable. Median TTP and OS were 6.5 (95% CI: 2.7-10.2) and 9.4 (95% CI: 6.3-12.6) months, respectively, with a median follow up of 18.7 months for the two surviving patients. One additional patient is initiating bevacizumab monotherapy (not included in this analysis).
Conclusions: Bevacizuamb has efficacy in the treatment of recurrent ependymoma. Prospective study is warranted.