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The Effect of Bevacizumab on Vestibular Schwannoma Related to Neurofibromatosis Type 2

The Effect of Bevacizumab on Vestibular Schwannoma Related to Neurofibromatosis Type 2 AbstractIntroduction: We describe an Australian experience of infusional bevacizumab for vestibular schwannoma (VS) in neurofibromatosis type 2 patients, with specific focus on 3-dimensional tumour volume and audiometry.Method: Data was pooled from patients with symptomatic or progressive VS from 2009 to April 2018. Tumours were assessed as total volume per patient. Bevacizumab infusions were administered every 2-4 weeks. 3-D volumetric response (cm3) was determined through serial magnetic resonance imaging, at baseline and at 3-6-month intervals, until cessation of infusions following progression or prior to surgery. Volumetric response was defined as a reduction of volume ³ 20%, from baseline. Patients underwent interval pure tone audiometry. A decrease in the average pure tone analyses by 10dB indicated response.Results: Twenty-one VS tumours were identified in eleven patients. Median age was 26 (range 13 – 67yr). Average baseline tumour volume was 14.17cm3 (range 1.45cm3 - 38.51cm3). Tumour volume reduction >20% was shown in 7/11 patients (64%), indicating partial response, 2/11 (18%) patients showed stable disease, and 2/11 (18%) progressed. Average percentage tumour volume change was +4.45% from baseline (range -57% to 241%). 16 individual ears were tested, 3/16 (19%) of ears showed an average decibel reduction of 10dB or more, indicating response (average change 2.5dB, range -36dB to 81dB). 10/16 (63%) showed stable hearing, and 3/16 (19%) showed hearing deterioration.Conclusion: Bevacizumab is a useful agent for reducing tumour volume and improving hearing losses due to vestibular schwannoma in neurofibromatosis type 2 patients. These results reflect results described from the United Kingdom and United States. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Australasian Journal of Neuroscience de Gruyter

The Effect of Bevacizumab on Vestibular Schwannoma Related to Neurofibromatosis Type 2

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Publisher
de Gruyter
Copyright
© 2021 Simone Ardern-Holmes et al., published by Sciendo
eISSN
2208-6781
DOI
10.21307/ajon-2021-002
Publisher site
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Abstract

AbstractIntroduction: We describe an Australian experience of infusional bevacizumab for vestibular schwannoma (VS) in neurofibromatosis type 2 patients, with specific focus on 3-dimensional tumour volume and audiometry.Method: Data was pooled from patients with symptomatic or progressive VS from 2009 to April 2018. Tumours were assessed as total volume per patient. Bevacizumab infusions were administered every 2-4 weeks. 3-D volumetric response (cm3) was determined through serial magnetic resonance imaging, at baseline and at 3-6-month intervals, until cessation of infusions following progression or prior to surgery. Volumetric response was defined as a reduction of volume ³ 20%, from baseline. Patients underwent interval pure tone audiometry. A decrease in the average pure tone analyses by 10dB indicated response.Results: Twenty-one VS tumours were identified in eleven patients. Median age was 26 (range 13 – 67yr). Average baseline tumour volume was 14.17cm3 (range 1.45cm3 - 38.51cm3). Tumour volume reduction >20% was shown in 7/11 patients (64%), indicating partial response, 2/11 (18%) patients showed stable disease, and 2/11 (18%) progressed. Average percentage tumour volume change was +4.45% from baseline (range -57% to 241%). 16 individual ears were tested, 3/16 (19%) of ears showed an average decibel reduction of 10dB or more, indicating response (average change 2.5dB, range -36dB to 81dB). 10/16 (63%) showed stable hearing, and 3/16 (19%) showed hearing deterioration.Conclusion: Bevacizumab is a useful agent for reducing tumour volume and improving hearing losses due to vestibular schwannoma in neurofibromatosis type 2 patients. These results reflect results described from the United Kingdom and United States.

Journal

Australasian Journal of Neuroscience – de Gruyter

Published: May 1, 2021

Keywords: Bevacizumab; Vestibular Schwannoma; Neurofibromatosis Type 2; 3-D Volumetric Analysis; Audiometry

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