Activity of temozolomide and bevacizumab in the treatment of locally advanced, recurrent, and metastatic hemangiopericytoma and malignant solitary fibrous tumor.

Abstract

BACKGROUND:

Hemangiopericytomas and malignant solitary fibrous tumors (HPC/SFT) are rare, closely related sarcomas with unpredictable behavior that respond infrequently to chemotherapy. An optimal systemic treatment strategy for advanced HPC/SFT has not yet been identified.

METHODS:

We retrospectively analyzed the records of 14 patients with histopathologically confirmed HPC/SFT who were treated at The University of Texas MD Anderson Cancer Center between May 2005 and June 2007. All patients were treated with temozolomide 150 mg/m(2) orally on days 1-7 and days 15-21 and bevacizumab 5 mg/kg intravenously on days 8 and 22, repeated at 28-day intervals. Computed tomography assessment of tumor size and density (Choi criteria) was used to determine the best response to therapy. The Kaplan-Meier method was used to estimate progression-free survival.

RESULTS:

The median follow-up period was 34 months. Eleven patients (79%) achieved a Choi partial response, with a median time to response of 2.5 months. Two patients (14%) had stable disease as the best response, and 1 patient (7%) had Choi progressive disease as the best response. The estimated median progression-free survival was 9.7 months, with a 6-month progression-free rate of 78.6%. The most frequently observed toxic effect was myelosuppression.

CONCLUSION:

Combination therapy with temozolomide and bevacizumab is a generally well-tolerated and clinically beneficial regimen for HPC/SFT patients. Additional investigation in a controlled, prospective trial is warranted.

• Authors: Min S Park, Shreyaskumar R Patel, Joseph A Ludwig, Jonathan C Trent, Charles A Conrad, Alexander J Lazar, Wei-Lien Wang, Piyaporn Boonsirikamchai, Haesun Choi, Xuemei Wang, Robert S Benjamin, Dejka M Araujo
• Journal: Cancer (Cancer) Vol. 117 Issue 21 Pg. 4939-47 (Nov 01 2011) ISSN: 1097-0142 [Electronic] United States
• PMID: 21480200 (Publication Type: Journal Article, Research Support, N.I.H., Extramural)
• Copyright: Copyright © 2011 American Cancer Society.

Chemical References

• Antibodies, Monoclonal, Humanized
• Bevacizumab
• Dacarbazine
• Temozolomide

Topics

• Adult
• Aged
• Antibodies, Monoclonal, Humanized (administration & dosage)
• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Bevacizumab
• Dacarbazine (administration & dosage, analogs & derivatives)
• Female
• Hemangiopericytoma (drug therapy)
• Humans
• Male
• Middle Aged
• Neoplasm Metastasis
• Neoplasm Recurrence, Local
• Solitary Fibrous Tumors (drug therapy)
• Temozolomide
• Treatment Outcome