DIPG-12. OUTCOMES IN PEDIATRIC MALIGNANT CENTRAL NERVOUS SYSTEM TUMORS UTILIZING TEMOZOLOMIDE, BEVACIZUMAB, AND IRINOTECAN

High-grade glioma (HGG) and diffuse intrinsic pontine glioma (DIPG) are the most common high-grade glial tumors in pediatrics. Hummel et al. assessed the feasibility of bevacizumab (BVZ) ± temozolomide (TEM) with radiation, followed by BVZ, irinotecan (IRO) ± TEM. The regimen conferred no survival benefit to patients with DIPG. The study was limited by sample size. Further defining efficacy of this therapy is important. We aimed to examine the outcomes of patients with HGG and DIPG treated with BVZ, IRO, and TEM. This is a retrospective review of patients treated at Cincinnati Children’s Hospital from 03/2005 to 10/2022. We examined progression-free survival (PFS) and overall survival (OS). Descriptive analyses were used to examine age, sex, diagnosis, and tumor location. 47 patients were treated with BVZ, IRO ± TEM. Patients were 55% female and 45% male. Average age at diagnosis was 12 years. The diagnoses included patients with HGG (45%), DIPG (51%), and other tumor types (4%). 79% of patients were treated at initial diagnosis with the regimen of BVZ in addition to IRO ± TEM. 21% of patients were treated at progression. Median OS for patients with DIPG and HGG was 12.4 months and 35.9 months, respectively. 3-year OS for DIPG was 10.8% (SE 7.2%) and for HGG it was 48.6% (SE 11.0%). Median PFS for DIPG and HGG was 7.7 and 19.0 months, respectively. 1-year PFS for DIPG was 31.9% (SE 10.7%). For HGG it was 65.6% (SE 10.6%). 3-year PFS for HGG was 20.2% (SE 9.0%). The limitations of this study are that newly diagnosed and recurrent patients are included and the study does not examine radiologic and biologic data. Results from this study show promising data for OS and PFS. Additional studies are needed to further examine larger cohorts of patients to demonstrate survival benefit from this regimen.