Bevacizumab in combination with sequential high-dose chemotherapy in solid cancer, a feasibility study.
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Bevacizumab in combination with sequential high-dose chemotherapy in solid cancer, a feasibility study. / Jordan, K; Wolf, H H; Voigt, W; Kegel, T; Mueller, L P; Behlendorf, T; Sippel, C; Arnold, Dirk; Schmoll, H J.
in: BONE MARROW TRANSPL, Jahrgang 45, Nr. 12, 12, 2010, S. 1704-1709.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Bevacizumab in combination with sequential high-dose chemotherapy in solid cancer, a feasibility study.
AU - Jordan, K
AU - Wolf, H H
AU - Voigt, W
AU - Kegel, T
AU - Mueller, L P
AU - Behlendorf, T
AU - Sippel, C
AU - Arnold, Dirk
AU - Schmoll, H J
PY - 2010
Y1 - 2010
N2 - We evaluated the feasibility and toxicity of bevacizumab in combination with sequential high-dose (HD) ifosfamide, carboplatin and etoposide refractory to standard chemotherapy in patients with sarcoma and germ cell cancer (GCC). Sixteen patients (13 sarcomas, 3 GCC) received SD-ICE followed by 4 cycles of HD-ICE, qd22 with stem cell support in combination with bevacizumab. All 16 patients were evaluable for toxicity and efficacy, and received 51 cycles (median 3.3). There was no increase in toxicity except of a relatively high incidence of ifosfamide encephalopathy in 17 cycles when compared with previous HD-ICE protocols. One almost complete response in the patient with GCC, previously progressive with three preceding protocols, was observed. Six patients had a partial response (sarcoma 4/13 patients; GCC 2/3 patients), and five patients stable disease (sarcoma 5/13 patients). The median PFS/OS for sarcoma was 5 months (confidence interval (CI): 3.1-6.9) and 13 months (CI: 3.6-24.4), respectively. To our knowledge, this is the first report of the addition of bevacizumab to HD-ICE. This combination did not show new unexpected toxicities except for a relatively high rate of ifosfamide encephalopathy. The efficacy in these heavily pretreated patients including possible reversal of chemotherapy resistance by the addition of bevacizumab indicates a possible potential of bevacizumab in this combination.
AB - We evaluated the feasibility and toxicity of bevacizumab in combination with sequential high-dose (HD) ifosfamide, carboplatin and etoposide refractory to standard chemotherapy in patients with sarcoma and germ cell cancer (GCC). Sixteen patients (13 sarcomas, 3 GCC) received SD-ICE followed by 4 cycles of HD-ICE, qd22 with stem cell support in combination with bevacizumab. All 16 patients were evaluable for toxicity and efficacy, and received 51 cycles (median 3.3). There was no increase in toxicity except of a relatively high incidence of ifosfamide encephalopathy in 17 cycles when compared with previous HD-ICE protocols. One almost complete response in the patient with GCC, previously progressive with three preceding protocols, was observed. Six patients had a partial response (sarcoma 4/13 patients; GCC 2/3 patients), and five patients stable disease (sarcoma 5/13 patients). The median PFS/OS for sarcoma was 5 months (confidence interval (CI): 3.1-6.9) and 13 months (CI: 3.6-24.4), respectively. To our knowledge, this is the first report of the addition of bevacizumab to HD-ICE. This combination did not show new unexpected toxicities except for a relatively high rate of ifosfamide encephalopathy. The efficacy in these heavily pretreated patients including possible reversal of chemotherapy resistance by the addition of bevacizumab indicates a possible potential of bevacizumab in this combination.
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Antibodies, Monoclonal administration
KW - dosage
KW - Combined Modality Therapy
KW - Etoposide administration
KW - Ifosfamide administration
KW - Feasibility Studies
KW - Neoplasms, Germ Cell and Embryonal drug therapy
KW - Antineoplastic Combined Chemotherapy Protocols adverse effects
KW - Carboplatin administration
KW - Peripheral Blood Stem Cell Transplantation
KW - Sarcoma drug therapy
KW - Adult
KW - Humans
KW - Male
KW - Female
KW - Middle Aged
KW - Young Adult
KW - Antibodies, Monoclonal administration
KW - dosage
KW - Combined Modality Therapy
KW - Etoposide administration
KW - Ifosfamide administration
KW - Feasibility Studies
KW - Neoplasms, Germ Cell and Embryonal drug therapy
KW - Antineoplastic Combined Chemotherapy Protocols adverse effects
KW - Carboplatin administration
KW - Peripheral Blood Stem Cell Transplantation
KW - Sarcoma drug therapy
M3 - SCORING: Zeitschriftenaufsatz
VL - 45
SP - 1704
EP - 1709
JO - BONE MARROW TRANSPL
JF - BONE MARROW TRANSPL
SN - 0268-3369
IS - 12
M1 - 12
ER -
