Efficacy of first line of bevacizumab in patients with neurofibromatosis 2-related vestibular schwannomas.

IF 2.2
Vladimír Koucký, Michaela Jirkovská, Aleš Vlasák, Lenka Kinštová, Jan Lazák, Eduard Zveřina, Jan Betka, Bořivoj Petrák, Pavel Tesner, Emilie Vyhnálková, Zdeněk Fík
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Abstract

Purpose: NF2-related schwannomatosis (NF2) patients are predisposed to develop multiple peripheral and central nervous tumors including bilateral vestibular schwannomas (VS). Decision on patient management, especially in large growing tumors, might be challenging concerning possible treatment-related complications and quality of life. Systemic therapy with bevacizumab has been reported to slow VS growth and improve hearing. Here, we present single-center outcomes of NF2 patients treated with bevacizumab.

Methods: We conducted a retrospective analysis of 15 NF2 patients with morphologically diagnosed unilateral or bilateral VS indicated for systemic therapy with bevacizumab (5 mg/kg every 2 weeks) in 2015-2022. Tumor growth rate, volume, and hearing thresholds were assessed before, during, and after first-line bevacizumab therapy.

Results: 15 patients (5 male, 10 females, mean age at the start of the therapy 30y, mean no. of bevacizumab cycles 35) and 25 tumors were evaluated. Radiologically significant (> 20% from the baseline) tumor volume reduction was observed in 5 patients. Notably, in patients with bilateral VS, volume reduction occurred on only one side. Three patients demonstrated a significantly reduced growth rate and tumor stabilization. Hearing improvement was documented in 1 patient, while another experienced significant hearing decline.

Conclusion: Bevacizumab therapy may contribute to tumor shrinkage and hearing stabilization in NF2 patients. However, treatment response is variable, with meaningful tumor reduction and hearing improvement observed only in a minority of cases.

贝伐单抗一线治疗神经纤维瘤病2相关前庭神经鞘瘤的疗效。
目的:NF2相关神经鞘瘤病(NF2)患者易患多发性外周和中枢神经肿瘤,包括双侧前庭神经鞘瘤(VS)。决定患者的管理,特别是在大的生长肿瘤,可能是具有挑战性的可能的治疗相关并发症和生活质量。据报道,全身治疗贝伐单抗可减缓VS生长并改善听力。在这里,我们介绍了使用贝伐单抗治疗的NF2患者的单中心结果。方法:我们对2015-2022年15例形态学诊断为单侧或双侧VS的NF2患者进行了回顾性分析,这些患者需要接受贝伐单抗(5 mg/kg / 2周)的全身治疗。在一线贝伐单抗治疗之前、期间和之后评估肿瘤生长率、体积和听力阈值。结果:15例患者(男5例,女10例),治疗开始时平均年龄30y,平均年龄30y。在贝伐单抗周期中评估了35例和25例肿瘤。5例患者观察到放射学上显著的肿瘤体积缩小(比基线缩小20%)。值得注意的是,在双侧VS患者中,体积缩小仅发生在一侧。3例患者表现出明显的生长速度降低和肿瘤稳定。1例患者听力改善,另1例患者听力明显下降。结论:贝伐单抗治疗可能有助于NF2患者的肿瘤缩小和听力稳定。然而,治疗反应是可变的,只有在少数病例中观察到有意义的肿瘤缩小和听力改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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