J Neurol Surg B Skull Base 2013; 74 - A041
DOI: 10.1055/s-0033-1336173

Anti-Angiogenic Agents for Non-Malignant Brain Tumors

Ammar H. Hawasli 1(presenter), Joshua B. Rubin 1, David D. Tran 1, Douglas R. Adkins 1, Shahid Waheed 1, Timothy E. Hullar 1, David H. Gutmann 1, John Evans 1, Michael R. Chicoine 1
  • 1St. Louis, MO, USA

Objective: To assess the treatment response and side effects for the use of vascular endothelial growth factor (VEGF) inhibitors for patients with vestibular schwannomas and meningiomas.

Methods: Retrospective review of eight male and two female patients (ages 14-70 years; mean, 36 years), treated with bevacizumab (9) or Panopazib (1). Six patients had neurofibromatosis type 2 (NF2) with bilateral vestibular schwannomas and meningiomas, whereas the four others had aggressive recurrent meningiomas.

Results: During treatment (range, 4-21 months; mean, 9.1 months) with VEGF inhibitors, two patients with an atypical meningioma and radiation necrosis had dramatic partial response, the six NF2 patients had stable or slightly improved disease, and two meningioma patients had disease progression. Hearing was stable in three of the NF2 patients and was improved in three NF2 patients (one of whom received a cochlear implant). Minor toxicities included epistaxis, nausea, diarrhea, weight loss, and abdominal pain. No grade 3 or 4 toxicities were observed.

Conclusion: VEGF inhibitors appear to be safe for the treatment of patients with benign brain tumors, and in select cases, may be efficacious.