Treatment options for recurrent glioblastoma are scarce; targeted therapy trials were disappointing, probably due to enrollment of patients without molecular selection. We treated with bevacizumab and erlotinib a 66-year-old male suffering from recurrent glioblastoma, IDH-wildtype and MGMT unmethylated, after three neurosurgeries. Treatment was tailored on molecular profile of recurrent tumor-namely, EGFRvIII positivity, VEGF overexpression, normal PTEN, low total VEGF and VEGF-121 mRNA-and resulted in complete, exceptionally durable response (51-month progression-free survival). Notably, histology of further recurrence after therapy was reminiscent of sarcoma. We suggest a thorough molecular screening for personalization of targeted therapy in recurrent glioblastoma
D'Alessandris, Q. G., Montano, N., Martini, M., Cenci, T., Lauretti, L., Stumpo, V., Pignotti, F., Olivi, A., Fernandez Marquez, E. M., E,, Larocca, L. M., Pallini, R., Eight-year survival of a recurrent glioblastoma patient treated with molecularly tailored therapy: a case report, <<ACTA NEUROCHIRURGICA>>, 2018; (160): 2387-2391. [doi:10.1007/s00701-018-3697-3] [http://hdl.handle.net/10807/130542]
Eight-year survival of a recurrent glioblastoma patient treated with molecularly tailored therapy: a case report
D'Alessandris, Quintino Giorgio;Montano, Nicola;Martini, Maurizio;Cenci, Tonia;Lauretti, Liverana;Pignotti, Fabrizio;Olivi, Alessandro;Fernandez Marquez, Eduardo Marcos;Larocca, Luigi Maria;Pallini, Roberto
2018
Abstract
Treatment options for recurrent glioblastoma are scarce; targeted therapy trials were disappointing, probably due to enrollment of patients without molecular selection. We treated with bevacizumab and erlotinib a 66-year-old male suffering from recurrent glioblastoma, IDH-wildtype and MGMT unmethylated, after three neurosurgeries. Treatment was tailored on molecular profile of recurrent tumor-namely, EGFRvIII positivity, VEGF overexpression, normal PTEN, low total VEGF and VEGF-121 mRNA-and resulted in complete, exceptionally durable response (51-month progression-free survival). Notably, histology of further recurrence after therapy was reminiscent of sarcoma. We suggest a thorough molecular screening for personalization of targeted therapy in recurrent glioblastoma
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