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Bevacizumab treatment for vestibular schwannomas in neurofibromatosis type two: report of two cases, including responses after prior gamma knife and vascular endothelial growth factor inhibition therapy

Published online by Cambridge University Press:  18 October 2011

G K Eminowicz ,
R Raman ,
J Conibear  and
P N Plowman
G K Eminowicz*
Affiliation:
Radiotherapy Department, St Bartholomew's Hospital, London, UK
R Raman
Affiliation:
Radiotherapy Department, St Bartholomew's Hospital, London, UK
J Conibear
Affiliation:
Radiotherapy Department, St Bartholomew's Hospital, London, UK
P N Plowman
Affiliation:
Radiotherapy Department, St Bartholomew's Hospital, London, UK
*
Address for correspondence: Dr Gemma Eminowicz, Radiotherapy Department, St Bartholomew's Hospital, London EC1A 7BE, UK E-mail: eminowicz@doctors.org.uk
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Abstract

Objectives:

Vestibular schwannomas are the hallmark of neurofibromatosis type two. They are difficult to treat, due to their bilateral presentation and the quest for hearing preservation. Our report describes a new treatment approach in this clinical scenario.

Case report:

We report two cases which confirm that bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor, causes regression of vestibular schwannomas in patients with a previous history of gamma knife radiosurgery or failed treatment with another form of vascular endothelial growth factor targeted therapy.

Conclusion:

In 2009, Plotkin et al. reported the volumetric response of vestibular schwannomas to bevacizumab treatment, both in untreated patients and in patients previously treated with erlotinib, an epidermal growth factor receptor inhibitor. The presented cases support the use of bevacizumab to treat vestibular schwannomas. Given the extremely slow growth of these tumours, we note the rapidity of volume reduction following bevacizumab therapy.

Keywords

Neurofibromatosis Type 2BevacizumabVascular Endothelial Growth FactorVestibular SchwannomaAcoustic Neuroma
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 1 , January 2012 , pp. 79 - 82
Copyright
Copyright © JLO (1984) Limited 2011

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