Optimizing bevacizumab dosing in glioblastoma: less is more. Journal of neuro-oncology Ajlan, A., Thomas, P., Albakr, A., Nagpal, S., Recht, L. 2017; 135 (1): 99-105

Abstract

Compared to traditional chemotherapies, where dose limiting toxicities represent the maximum possible dose, monoclonal antibody therapies are used at doses well below maximum tolerated dose. However, there has been little effort to ascertain whether there is a submaximal dose at which the efficacy/complication ratio is maximized. Thus, despite the general practice of using Bevacizumab (BEV) at dosages of 10 mg/kg every other week for glioma patients, there has not been much prior work examining whether the relatively high complication rates reported with this agent can be decreased by lowering the dose without impairing efficacy. We assessed charts from 80 patients who received BEV for glioblastoma to survey the incidence of complications relative to BEV dose. All patients were treated with standard upfront chemoradiation. The toxicity was graded based on the NCI CTCAE, version 4.03. The rate of BEV serious related adverse events was 12.5% (n?=?10/80). There were no serious adverse events (=grade 3) when the administered dose was (<3 mg/kg/week), compared to a 21% incidence in those who received higher doses (=3 mg/kg/week) (P?

View details for DOI 10.1007/s11060-017-2553-2

View details for PubMedID 28667595