Low-dose bevacizumab induces radiographic regression of vestibular schwannomas in neurofibromatosis type 2: A case report and literature review

May 2016
Oncology Letters;May2016, Vol. 11 Issue 5, p2981
Academic Journal
Case Study
The current case study aimed to explore the efficacy of a low-dose bevacizumab regimen in inhibiting tumor growth and minimizing adverse effects. A 55-year-old man with neurofibromatosis type 2 (NF2) suffered bilateral vestibular schwannomas (VS) measuring 5.25 and 2.54 cm³ on the left and right, respectively. His capacity for bilateral language recognition was impaired. However, the patient refused microsurgical tumor resection and gamma knife therapy. Low-dose bevacizumab regimen (3.3-2.2 mg/kg every 2-4 weeks) was administered by intravenous injection for ~1.5 years to inhibit tumor growth and avoid further deterioration of hearing. Compared with baseline measurements prior to treatment, the bilateral VS regressed to 3.59 cm³ (68%) and 2.08 cm³ (82%) on the left and right, respectively. No hearing improvement was detected; however, the patient subjectively experienced a significant hearing improvement as his ability to communicate with people and distinguish voices was restored. No adverse effects were observed. Bevacizumab provides an alternative treatment option for those who refuse surgical intervention. Given the adverse effects commonly induced by bevacizumab, the use of a low-dose regimen would appear to be promising with regard to tumor regression and hearing preservation for patients with VS in NF2. However, the minimum dose required to sustain a response to bevacizumab in NF2 patients remains unknown. Finding the minimum effective dose sufficient to sustain hearing and/or volumetric response for individual patients is required.


Related Articles

  • Long-term toxicity of bevacizumab therapy in neurofibromatosis 2 patients. Slusarz, Katherine; Merker, Vanessa; Muzikansky, Alona; Francis, Sanjeev; Plotkin, Scott // Cancer Chemotherapy & Pharmacology;Jun2014, Vol. 73 Issue 6, p1197 

    Purpose: Bevacizumab treatment is associated with tumor shrinkage and hearing improvement in about 50 % of neurofibromatosis 2 (NF2) patients with progressive vestibular schwannomas. Hypertension and proteinuria are common side effects of treatment. However, the long-term toxicity of bevacizumab...

  • Bevacizumab in Neurofibromatosis type 2 (NF2) related vestibular schwannomas: a nationally coordinated approach to delivery and prospective evaluation. Morris, Katrina A.; Golding, John F.; Axon, Patrick R.; Afridi, Shazia; Blesing, Claire; Ferner, Rosalie E.; Halliday, Dorothy; Jena, Raj; Pretorius, Pieter M.; Evans, D. Gareth; McCabe, Martin G.; Parry, Allyson // Neuro-Oncology Practice;Dec2016, Vol. 3 Issue 4, p281 

    Background. NF2 patients develop multiple nervous system tumors including bilateral vestibular schwannomas (VS). The tumors and their surgical treatment are associated with deafness, neurological disability, and mortality. Medical treatment with bevacizumab has been reported to reduce VS growth...

  • High hopes, realistic expectations drive bevacizumab treatment. Lawrence, Leah // Hem/Onc Today;5/25/2011, Vol. 12 Issue 10, p1 

    The article discusses the high expectations for the therapeutic use of anti-angiogenic bevacizumab and cites the views of some oncologists on the negative attention that bevacizumab has received.

  • Bevacizumab.  // Reactions Weekly;6/5/2010, Issue 1304, p11 

    The article describes the case of a 76-year-old woman and a 74-year-old man who acquired macular ischaemia after intravitreal administration of bevacizumab.

  • Treatment of polypoidal choroidal vasculopathy with intravitreal bevacizumab monotherapy. Tan, Colin S. H.; Lim, Louis W.; Wei Kiong Ngo; Kai Xiong Cheong // Indian Journal of Ophthalmology;Nov2013, Vol. 61 Issue 11, p684 

    A letter to the editor is presented in response to the article "Intravitreal bevacizumab monotherapy for treatment-naïve polypoidal choroidal vasculopathy" by JK Chhablani and colleagues in 2013 issue.

  • Antiangiogenic therapy of brain tumors: the role of bevacizumab. Trevisan, Elisa; Bertero, Luca; Bosa, Chiara; Magistrello, Michela; Pellerino, Alessia; Rudà, Roberta; Soffietti, Riccardo // Neurological Sciences;Apr2014, Vol. 35 Issue 4, p507 

    Angiogenesis is one of the hallmarks of cancer, including brain tumors. Malignant gliomas have the highest degree of vascular proliferation among solid tumors; thus, angiogenic pathways represent an attractive target to interfere with tumor growth. Up to date VEGF pathway targeting with specific...

  • Bevacizumab.  // Reactions Weekly;6/5/2010, Issue 1304, p11 

    The article describes the case of 11 patients who developed various eye disorders following intravitreal administration of bevacizumab.

  • Blood test could allow individualized treatment of ovarian cancer with bevacizumab.  // British Journal of Hospital Medicine (17508460);Oct2014, Vol. 75 Issue 10, p549 

    The article discusses the findings of a study which reveals that a novel blood test can be used for individualized treatment of ovarian cancer using bevacizumab.

  • Avastin could potentially result in huge cost savings in the UK.  // PharmacoEconomics & Outcomes News;5/26/2012, Issue 654, p2 

    The article discusses research on the effectiveness of avastin for treating wet age-related macular degeneration (AMD) which could result to huge cost savings in Great Britain.

  • Bevacizumab for macular degeneration and other retinal disorders. Lotery, Andrew; MacEwen, Carrie // BMJ: British Medical Journal;11/22/2014, Vol. 349 Issue 7894, pg6887 

    The authors stress the need for the British government to act to remove the hurdles from preventing the use of bevacizumab for the treatment of age related macular degeneration (AMD). It notes that the National Institute for Health and Care Excellence (NICE) and the General Medical Council (GMC)...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics