After withdrawal of bevacizumab in patients with recurrent high−grade glioma, we have observed a rapid tumour re−growth or "rebound" radiographic phenomenon with accelerated clinical decline. We retrospectively reviewed 11 patients treated at the Henry Ford Hermelin Brain Tumor Center with recurrent high−grade glioma who demonstrated a rebound progression pattern after the discontinuation of bevacizumab. The original tumour area−of−enhancement increased by a mean of 158%, when compared to the rebound magnetic resonance imaging. After rebound, no patients (0/8) showed a response to next−line treatments that did not include bevacizumab. The median survival of those re−treated with bevacizumab was 149 and 32 days for those who received other regimens. Abrupt discontinuation of bevacizumab after recurrence often leads to a dramatic rebound phenomenon and rapid clinical decline. Slow tapering of the bevacizumab dose after tumour progression may prevent this from occurring and improve responsiveness to next−line therapies.

PMID: 20151176 [PubMed − as supplied by publisher] Source: National Library of Medicine.