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  • Jul 30, 2018
    Randomized Multicenter Trial of Bevacizumab in Pediatric Patients With Newly Diagnosed High-Grade Glioma

    This study provides a very important perspective onthe role of Avastin (Bevacizumab) in the optimization of the postoperative management of one of the most common aggressive childhood type of tumors –high-grade gliomas (HGGs). The authors of the study conducted a randomized multi-center open-label investigation in order to assess event-free survival (EFS) and overall survival (OS) rates after a standard radiotherapy (RT) + temozolomide (TMZ) adjuvant TMZ versus RT + TMZ + Bev (Bevacizumab) adjuvant TMZ + BEV.

    One of the major strengths of this studyis its randomized multi-institutional international design. Furthermore, given rarity of pediatric malignancies, a total of 116 patients were included for analysis, which is a relatively large number for this disease type. Overall, the study demonstrated that unlike adult high-grade gliomas, addition of Avastin to the standard therapy with RT+TMZ fails to improve EFS or OS in children with newly diagnosed HGG. These findings are an additional strength of the study as they indicate that a mere extrapolation of findings from the respective adult tumors to the pediatric malignancies is not often appropriate, therefore pediatric-specific investigations are paramount to improving care of this unique patient population.

    Some of the shortcomings of the study include a short follow-up, heterogeneity of enrolled participants, and low completion rate of one of the key quality of life questionnaires of the investigation.

    Overall, this publication contributes significantly to the relatively scarce literature on this important topic in the management of childhood high-grade gliomas, and will serve as a useful resource for both radiation and medical oncologists who care for children with cancer. Furthermore, it provides a platform with which we can guide future investigations.


    Journal & Date: Clinical Oncology 36, no. 10 (April 1 2018) 951-958
    Key Institution: International randomized trial (Australasian Children’s Cancer Trials, Innovative Therapies for Children with Cancer, the European Society of Pediatric Oncology
    Keywords: Pediatric brain tumors, high-grade glioma, bevacizumab, radiotherapy, temozolomide