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Annals of Oncology Advance Access originally published online on December 3, 2007
Annals of Oncology 2008 19(4):807-813; doi:10.1093/annonc/mdm510
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

pediatric malignancies

Compassionate use of bevacizumab (Avastin®) in children and young adults with refractory or recurrent solid tumors

M. Benesch1,*, M. Windelberg2, W. Sauseng1, V. Witt3, G. Fleischhack2, H. Lackner1, H. Gadner3, U. Bode2 and C. Urban1

1 Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Austria
2 Division of Pediatric Hematology and Oncology, Children's Hospital Medical Centre, Bonn, Germany
3 St Anna Children's Hospital Vienna, Austria

* Correspondence to: Dr M. Benesch, Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Auenbruggerplatz 30, A-8036 Graz, Austria. Tel: +43-316-38580427; Fax: +43-316-3853450; E-mail: martin.benesch{at}klinikum-graz.at

Background: The aim of this study was to evaluate feasibility and toxicity of bevacizumab (Avastin®), a monoclonal antibody directed against the vascular endothelial growth factor in children and young adults.

Patients and methods: Fifteen patients (male: n = 8; female: n = 7; median age, 14.6 years) received bevacizumab for recurrent or progressive solid tumors (carcinoma: n = 3; neuroblastoma: n = 2; astrocytoma grade III: n = 2; rhabdomyosarcoma: n = 2; nephroblastoma: n = 2; benign vascular tumors: n = 2; synovial sarcoma: n = 1; and malignant hemangiopericytoma: n = 1) on a compassionate basis. Bevacizumab was administered at 5–10 mg/kg body weight intravenously every 2–3 weeks. Most patients received chemotherapy in addition to bevacizumab. Duration of bevacizumab therapy ranged from 1.5 to 23 months.

Results: Bevacizumab-related side-effects were mild and included hypertonia (n = 2), proteinuria/hematuria (n = 2), epistaxis (n = 2), local erythema (n = 1), and defective wound healing and ascites (n = 1). Radiographic objective responses (partial responses) were observed in two patients with astrocytoma grade III and in one patient each with neuroblastoma and pleomorphic rhabdomyosarcoma, respectively.

Conclusions: 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.

Key words: angiogenesis, bevacizumab, children, refractory solid tumors

Received for publication September 18, 2007. Revision received October 1, 2007. Accepted for publication October 1, 2007.


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