Avastin for rahbdomyosarcoma – pro
A phase I and II studies suggested that there si benefit to adding bevacizumab to chemoehrpay for metastatic rhabdomyosarcoma. 1, 2. A study of compassionate use in children with solid tumors, inclusing rhabdomyosarcoma concluded that bevacizumab seems to have a good acute safety profile and some antitumor activity in heavily pretreated children and young adults with recurrent solid tumors. Prospective clinical trials are urgently needed to further evaluate the safety and efficacy of bevacizumab in pediatric patients. 3
In the phase 2 study, temsirolimus or bevacizumab (Avastin) was added to a chemotherapy regimen of vinorelbine and cyclophosphamide in patients with an unfavorable prognosis at first relapse or disease progression. Event-free survival was better in the temsirolimus group than in the bevacizumab group (65% vs 50%), but there was no difference in overall survival. However, results from another study presented at the meeting were disappointing. In children with intermediate-risk rhabdomyosarcoma, the addition of irinotecan to the combination of vincristine, dactinomycin, and cyclophosphamide (VAC) did not improve event-free or overall survival. 4
I am not aware of any trials of this drug as maintenance for rahbdomyosarcoma.
1.Julia L. Glade Bender, Peter C. Adamson, Joel M. Reid, Lu Xu, Sylvain Baruchel, Yuval Shaked,
Robert S. Kerbel, Erin M. Cooney-Qualter, Diana Stempak, Helen X. Chen, Marvin D. Nelson, Mark D. Krailo,Ashish M. Ingle, Susan M. Blaney, Jessica J. Kandel, and Darrell J. Yamashiro, Phase I Trial and Pharmacokinetic Study of Bevacizumab in Pediatric Patients With Refractory Solid Tumors: A Children’s Oncology Group Study. J Clin Oncol 26:399-405. © 2008
:
2. Julia C. Chisholm, Michela Casanova, Johannes H. Merks, Birgit Geoerger, Raphael F. Rousseau, Nicola Moore, Christophe Dhalluin, Odile Oberlin, on behalf of the European Innovative Therapies for Children with Cancer (ITCC) Consortium and the European Paediatric Soft Tissue Sarcoma Group (EpSSG); The Royal Marsden NHS Foundation Trust, Sutton, United Kingdom; National Cancer Institute, Milan, Italy; Emma Children’s Hospital/Academic Medical Center, University of Amsterdam, Amsterdam, Netherlands; Institut Gustave Roussy, Villejuif, France; F. Hoffmann-La Roche Ltd., Basel, Switzerland, nThe BERNIE study: A phase II study evaluating addition of bevacizumab (Bv) to chemotherapy in children and adolescents with metastatic rhabdomyosarcoma (mRMS) and non-rhabdomyosarcoma soft tissue sarcoma (mNRSTS).J Clin Oncol 30, 2012 (suppl; abstr TPS9597^)
3.M. Benesch, Compassionate use of bevacizumab (Avastin®) in children and young adults with refractory or recurrent solid tumors. Ann Oncol (2008) 19 (4): 807-813.
4.(abstract 10003) presented at the 2014 ASCO