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Prolonged treatment with bevacizumab is associated with brain atrophy: a pilot study in patients with high-grade gliomas

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Abstract

Bevacizumab is widely used for treatment of high-grade gliomas and other malignancies. Because bevacizumab has been shown to be associated with neurocognitive decline, this study is designed to investigate whether prolonged treatment with bevacizumab is also associated with brain atrophy. We identified 12 high-grade glioma patients who received bevacizumab for 12 months at the first recurrence and 13 matched controls and blindly compared the volumes of the contralateral hemispheres and contralateral ventricle in these two groups at baseline and after 12 ± 2 months of the baseline scan by two independent analyses. The volumes of the contralateral hemispheres and ventricles did not differ significantly between the two groups at baseline. Whereas, in the control group the volumes of the contralateral hemisphere changed subtly from baseline to follow-up (p = 0.23), in the bevacizumab-treated group the volumes significantly decreased from baseline to follow-up (p = 0.03). There was significant increase in the contralateral ventricle volume from base line to follow-up scans in both the control group (p = 0.01) and in the bevacizumab group (p = 0.005). Both the absolute and the percentage changes of contralateral hemisphere volumes and contralateral ventricular volumes between the two patient groups were statistically significant (p < 0.05). Results of this study demonstrate prolonged treatment with bevacizumab is associated with atrophy of the contralateral brain hemisphere.

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Conflict of interests

AKB: Consultant to Dotarem Advisory board. Guerbet LLc. HK: No disclosure. YG: No disclosure. MB: No disclosure. PPW: No disclosure. HMF: No disclosure. DG: No disclosure. JMM: Leadership role, Stocks, Consultancy, Intellectual property and Research Funding: Catherex Inc. & Aettis Inc.; Research funding: ICT. JF: Research funding: Varian Oncology. TMB: No disclosure. AK: No disclosure. GKF: No disclosure. PRC: No disclosure. LBN: Consultant, Merck Inc.; Travel allowance: BMS. XH: No disclosure.

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Authors and Affiliations

  1. Department of Radiology, The University of Alabama at Birmingham, Birmingham, USA

    Asim K. Bag, Hyunki Kim, Mark Bolding, Demet Gurler & Philip R. Chapman

  2. Department of Biomedical Informatics, Stony Brook University, New York, USA

    Yi Gao

  3. Department of Neurology, The University of Alabama at Birmingham, FOT 1020; 510 20th Street South, Birmingham, AL, 35294, USA

    Paula P. Warren, Hassan M. Fathallah-Shaykh, Ayaz Khawaja, Louis B. Nabors & Xiaosi Han

  4. Department of Neurosurgery, The University of Alabama at Birmingham, Birmingham, USA

    James M. Markert

  5. Department of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, USA

    John Fiveash

  6. Department of Biostatistics, The University of Alabama at Birmingham, Birmingham, USA

    Timothy M. Beasley

  7. Department of Hematology Oncology, The University of Alabama at Birmingham, Birmingham, USA

    Gregory K. Friedman

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  1. Asim K. Bag
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Correspondence to Xiaosi Han.

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Supplementary material 1 (DOCX 73 kb)

11060_2015_1751_MOESM3_ESM.tiff

Box plots showing contralateral hemisphere and ventricle volumes from the initial analysis. (A, B) Contralateral hemisphere volumes at baseline and follow-up scans of patients treated with (A) combination of bevacizumab and standard of the care (labeled as Bevacizumab) or (B) only standard of the care (labeled as control). (C, D) Contralateral ventricle volumes at baseline and follow-up scans of patients treated with (A) combination of bevacizumab and standard of the care or (B) only standard of the care. Supplementary material 3 (TIFF 332 kb)

11060_2015_1751_MOESM2_ESM.tiff

3D volume renderings of contralateral hemisphere and ventricle at baseline and follow-up scans of two representative patients treated with (A) combination of bevacizumab and standard of the care (labeled as Bevacizumab) and (B) only standard of the care (labeled as Control). Same size scale was applied for all hemispheres (or ventricles). This image is from the initial analysis. Supplementary material 2 (TIFF 428 kb)

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Bag, A.K., Kim, H., Gao, Y. et al. Prolonged treatment with bevacizumab is associated with brain atrophy: a pilot study in patients with high-grade gliomas. J Neurooncol 122, 585–593 (2015). https://doi.org/10.1007/s11060-015-1751-z

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