Complete response with fotemustine and bevacizumab after early progression following radiotherapy and temozolomide treatment in patient with glioblastoma multiforme

Abstract

Glioblastoma multiforme is the most common type of primary central nervous system tumor and is noted for its short survival and poor response to chemotherapeutic agents. Unfortunately, the relapse rate is very high, and there is no reference drug for second-line treatment. In this study, a patient was treated with the Soffietti regimen. The induction phase was fotemustine 75 mg/m² at day 1 and day 8 and bevacizumab 10 mg/kg at day 1 and day 15. The maintenance phase was fotemustine 75 mg/m² and bevacizumab 10 mg/kg every 3 weeks for two cycles. Follow-up magnetic resonance imaging showed post-surgical changes at the left occipital level, without contrast enhancement, and toxic left leuko-encephalopathy post-treatment without mass effect and with no evidence of tumor residue. The patient then was maintained with bevacizumab monotherapy until it was withdrawn when pulmonary thromboembolism occurred. Following tumor regrowth, fotemustine was started again as maintenance therapy. The patient achieved stabilization of his disease until his death due to thromboembolic and infectious complications.

Keywords

Bevacizumab / brain tumor / fotemustine

References

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