Format

Send to

Choose Destination
J Neurosurg. 2011 Mar;114(3):624-32. doi: 10.3171/2010.9.JNS101223. Epub 2010 Oct 22.

Safety and maximum tolerated dose of superselective intraarterial cerebral infusion of bevacizumab after osmotic blood-brain barrier disruption for recurrent malignant glioma. Clinical article.

Author information

1
Departments of Neurosurgery, Weill Medical College of Cornell University, 510 East 70th Street, New York, New York 10021, USA. jab2029@med.cornell.edu

Abstract

OBJECT:

The authors assessed the safety and maximum tolerated dose of superselective intraarterial cerebral infusion (SIACI) of bevacizumab after osmotic disruption of the blood-brain barrier (BBB) with mannitol in patients with recurrent malignant glioma.

METHODS:

A total of 30 patients with recurrent malignant glioma were included in the current study.

RESULTS:

The authors report no dose-limiting toxicity from a single dose of SIACI of bevacizumab up to 15 mg/kg after osmotic BBB disruption with mannitol. Two groups of patients were studied; those without prior bevacizumab exposure (naïve patients; Group I) and those who had received previous intravenous bevacizumab (exposed patients; Group II). Radiographic changes demonstrated on MR imaging were assessed at 1 month postprocedure. In Group I patients, MR imaging at 1 month showed a median reduction in the area of tumor enhancement of 34.7%, a median reduction in the volume of tumor enhancement of 46.9%, a median MR perfusion (MRP) reduction of 32.14%, and a T2-weighted/FLAIR signal decrease in 9 (47.4%) of 19 patients. In Group II patients, MR imaging at 1 month showed a median reduction in the area of tumor enhancement of 15.2%, a median volume reduction of 8.3%, a median MRP reduction of 25.5%, and a T2-weighted FLAIR decrease in 0 (0%) of 11 patients.

CONCLUSIONS:

The authors conclude that SIACI of mannitol followed by bevacizumab (up to 15 mg/kg) for recurrent malignant glioma is safe and well tolerated. Magnetic resonance imaging shows that SIACI treatment with bevacizumab can lead to reduction in tumor area, volume, perfusion, and T2-weighted/FLAIR signal.

PMID:
20964595
PMCID:
PMC3622705
DOI:
10.3171/2010.9.JNS101223
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Sheridan PubFactory Icon for PubMed Central
Loading ...
Support Center