A Phase II Trial of Bevacizumab in Patients with Recurrent/Progressive Solid Tumor Brain Metastases That Have Progressed Following Whole-Brain Radiation Therapy

Karan Dixit, Lauren Singer, Sean Aaron Grimm, Rimas V. Lukas, Margaret A. Schwartz, Alfred Rademaker, Hui Zhang, Masha Kocherginsky, Sofia Chernet, Laura Sharp, Valerie Nelson, Jeffrey J. Raizer, Priya Kumthekar*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Patients with solid tumor brain metastases that progress after whole-brain radiation have limited options. This prospective trial investigated the efficacy, safety, and tolerability of bevacizumab as salvage therapy in this population. Eligible patients received bevacizumab 10 mg/kg intravenously every 2 weeks until progression. The primary endpoint was radiologic response using Response Assessment in Neuro-Oncology (RANO) criteria. The secondary endpoints were progression-free survival (PFS), overall survival (OS), duration of response, and safety. Quality of life (QOL) was studied using the Functional Assessment of Cancer Therapy-Brain (FACT-Br) scale. Twenty-seven patients were enrolled, with twenty-four having evaluable data for response. The majority of histologies (n = 21, 78%) were breast cancer. The remaining histologies were non-small-cell lung cancer (n = 4, 15%), neuroendocrine cancer (n = 1, 3%), and papillary fallopian serous adenocarcinoma (n = 1, 3%). Eighteen patients had radiologic response, with two patients demonstrating partial response (8.33%) and sixteen patients demonstrating stable disease (66.7%). The median duration of response was 203 days. PFS at 6 months was 46%, median PFS was 5.3 m, and median OS was 9.5 m. Treatment was well tolerated, with six patients experiencing grade 3 lymphopenia and hypertension. There was one grade 3 thromboembolism. QOL was not negatively impacted. Bevacizumab is a safe and feasible salvage treatment with durable response and favorable overall survival for patients with progressive brain metastases after whole-brain radiation.

Original languageEnglish (US)
Article number2133
JournalCancers
Volume16
Issue number11
DOIs
StatePublished - Jun 2024

Funding

This study was funded by Genentech through an investigator-initiated trial grant.

Keywords

  • bevacizumab
  • brain metastasis
  • survival
  • whole-brain radiotherapy

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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