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DIPG-02. Role of a Bevacizumab-based regime in the treatment of children with diffuse intrinsic pontine glioma (DIPG): a systematic review

DIPG-02. Role of a Bevacizumab-based regime in the treatment of children with diffuse intrinsic pontine glioma (DIPG): a systematic review
DIPG-02. Role of a Bevacizumab-based regime in the treatment of children with diffuse intrinsic pontine glioma (DIPG): a systematic review
Background: diffuse intrinsic pontine glioma (DIPG) is an aggressive paediatric brainstem tumour. There are no effective treatments and median survival is 11.2 months, therefore maintaining quality of life (QOL) is a priority for many families. Bevacizumab, an anti-VEGF IgG antibody, has the potential to improve QOL and survival in DIPG, but has never been evaluated systematically.

Aim: to collate the evidence and assess the role of this drug, in the treatment of DIPG.

Methods: MEDLINE, EMBASE, Scopus and Web of Science were searched for relevant studies using terms developed from PICO criteria, including alternatives for Bevacizumab and DIPG. One reviewer screened titles and abstracts, then two reviewers screened full texts. Data were extracted into tables and study quality assessed using MINORS and JBI tools. RESULTS: Searching revealed 1,001 papers; after deduplication 851 remained. After screening of titles and abstracts, 28 full texts were screened, resulting in the inclusion of 11 studies. All studies evaluated more than one outcome. Four studies reported a median overall survival longer than historical data, however, two determined no significant impact. Five studies reported a radiological response in a proportion of participants and two reported no response. Three studies evaluating clinical response, reported improvement in a proportion of patients. Three studies evaluating QOL reported stability or improvement. Four studies evaluating steroid use reported reductions in the proportion of patients receiving steroids. In the treatment of radiation necrosis, Bevacizumab led to clinical improvement in 6/12 patients in 2 studies and permitted a reduction in steroid use in the majority of patients.

Conclusion: insufficient evidence means the role of Bevacizumab in the treatment of DIPG is unclear. However, Bevacizumab may be beneficial to some patients. The review highlights the need for further research in this area, particularly randomised controlled trials. More effective therapies are desperately needed.
1522-8517
i17-i17
Evans, Mia
966ad338-cec2-4ba2-9737-8ece43bdbf06
Gill, Ria
e586730f-d95c-48a0-bef7-dabd069be021
Bull, Kim
751f8b25-29ba-4d4f-96e2-6c339a83a47f
Evans, Mia
966ad338-cec2-4ba2-9737-8ece43bdbf06
Gill, Ria
e586730f-d95c-48a0-bef7-dabd069be021
Bull, Kim
751f8b25-29ba-4d4f-96e2-6c339a83a47f

Evans, Mia, Gill, Ria and Bull, Kim (2022) DIPG-02. Role of a Bevacizumab-based regime in the treatment of children with diffuse intrinsic pontine glioma (DIPG): a systematic review. Neuro-Oncology, 24 (Supplement_1), i17-i17. (doi:10.1093/neuonc/noac079.059).

Record type: Meeting abstract

Abstract

Background: diffuse intrinsic pontine glioma (DIPG) is an aggressive paediatric brainstem tumour. There are no effective treatments and median survival is 11.2 months, therefore maintaining quality of life (QOL) is a priority for many families. Bevacizumab, an anti-VEGF IgG antibody, has the potential to improve QOL and survival in DIPG, but has never been evaluated systematically.

Aim: to collate the evidence and assess the role of this drug, in the treatment of DIPG.

Methods: MEDLINE, EMBASE, Scopus and Web of Science were searched for relevant studies using terms developed from PICO criteria, including alternatives for Bevacizumab and DIPG. One reviewer screened titles and abstracts, then two reviewers screened full texts. Data were extracted into tables and study quality assessed using MINORS and JBI tools. RESULTS: Searching revealed 1,001 papers; after deduplication 851 remained. After screening of titles and abstracts, 28 full texts were screened, resulting in the inclusion of 11 studies. All studies evaluated more than one outcome. Four studies reported a median overall survival longer than historical data, however, two determined no significant impact. Five studies reported a radiological response in a proportion of participants and two reported no response. Three studies evaluating clinical response, reported improvement in a proportion of patients. Three studies evaluating QOL reported stability or improvement. Four studies evaluating steroid use reported reductions in the proportion of patients receiving steroids. In the treatment of radiation necrosis, Bevacizumab led to clinical improvement in 6/12 patients in 2 studies and permitted a reduction in steroid use in the majority of patients.

Conclusion: insufficient evidence means the role of Bevacizumab in the treatment of DIPG is unclear. However, Bevacizumab may be beneficial to some patients. The review highlights the need for further research in this area, particularly randomised controlled trials. More effective therapies are desperately needed.

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noac079.059 - Version of Record
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e-pub ahead of print date: 3 June 2022
Published date: 3 June 2022
Venue - Dates: 20th International Symposium on Pediatric Neuro-Oncology, Congress Center Hamburg, Hamburg, Germany, 2022-06-12 - 2022-06-15

Identifiers

Local EPrints ID: 467676
URI: http://eprints.soton.ac.uk/id/eprint/467676
ISSN: 1522-8517
PURE UUID: f0ccbf37-5394-4868-a401-01a4aaa7a4f5
ORCID for Kim Bull: ORCID iD orcid.org/0000-0002-5541-4556

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Date deposited: 19 Jul 2022 16:37
Last modified: 29 Jul 2022 01:37

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Contributors

Author: Mia Evans
Author: Ria Gill
Author: Kim Bull ORCID iD

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