PEDT-05 USEFULNESS OF BEVACIZUMAB IN MAINTAINING QOL AT DIPG RELAPSE

INTRODUCTION: Even in the age of molecular diagnosis, diffuse intrinsic pontine glioma (DIPG) is still a dismal disease, and there is no effective treatment. The usefulness of bevacizumab for DIPG relapse is reported. SUBJECTS AND METHODS: The treatment and outcomes of 10 patients with DIPG who were treated at our institute since 2001 were retrospectively reviewed. All patients were diagnosed with DIPG by MRI imaging and underwent radiation therapy first. Chemotherapy was performed in combination with radiation therapy in 4 cases, and 3 of them did not receive chemotherapy at the time of relapse (Untreated Group). In 7 cases, chemotherapy was performed at the time of relapse with ACNU/vincristine or interferon beta (Other Treatment Group), and 2 cases with bevacizumab (Bv Group). The change in the Karnofsky Performance Status Scale (KPS) from the time of relapse was compared. RESULTS: The average overall survival (OS) for all 10 cases was 10.0 months, 8.1 months in the Untreated Group, 9.5 months in the Bv Group, and 11.4 months in the Other Treatment Group. No prolongation of OS by bevacizumab was observed. However, it was only in the Bv Group that the KPS increased from the time of relapse. Comparison of the KPS at the time of relapse and the KPS after 4 months showed that the Bv Group remained unchanged or increased from 80 to 90, while the Untreated Group decreased by 60–100, and the Other Treatment Group also decreased by 20–50. In the Other Treatment Group, hospitalization was required for treatment, and side effects of bone marrow suppression were observed. However, in the Bv Group, outpatient treatment was possible, there were no side effects, and all could be observed at home. CONCLUSION: From the above results, bevacizumab appears useful for palliative treatment for maintaining quality of life after DIPG relapse.