Compassionate use of bevacizumab (Avastin®) in children and young adults with refractory or recurrent solid tumors

Background: The aim of this study was to evaluate feasibility and toxicity of bevacizumab (Avastin (R)), a monoclonal antibody directed against the vascular endothelial growth factor in children and young adults. Patients and methods: Fifteen patients (male: n=8; female: n=7; median age, 14.6 years) received bevacizumab for recurrent or progressive solid tumors (carcinoma: n=3; neuroblastoma: n=2; astrocytoma grade III: n=2; rhabdomyosarcoma: n=2; nephroblastoma: n=2; benign vascular tumors: n=2; synovial sarcoma: n=1; and malignant hemangiopericytoma: n=1) on a compassionate basis. Bevacizumab was administered at 5 - 10 mg/ kg body weight intravenously every 2 - 3 weeks. Most patients received chemotherapy in addition to bevacizumab. Duration of bevacizumab therapy ranged from 1.5 to 23 months. Results: Bevacizumab- related side- effects were mild and included hypertonia (n=2), proteinuria/ hematuria (n=2), epistaxis (n=2), local erythema (n=1), and defective wound healing and ascites (n=1). Radiographic objective responses (partial responses) were observed in two patients with astrocytoma grade III and in one patient each with neuroblastoma and pleomorphic rhabdomyosarcoma, respectively. Conclusions: Bevacizumab seems to have a good acute safety profile and some antitumor activity in heavily pretreated children and young adults with recurrent solid tumors. Prospective clinical trials are urgently needed to further evaluate the safety and efficacy of bevacizumab in pediatric patients.