Low-Dose Bevacizumab for the Treatment of Focal Radiation Necrosis of the Brain (fRNB): A Single-Center Case Series
Abstract
Simple Summary Focal radiation necrosis of the brain (fRNB) is a late side effect that can occur after treatment of brain lesions with focal radiation therapy (stereotactic radiosurgery [SRS] or stereotactic radiation therapy [SRT]). This is becoming more common as more cancer patients are receiving effective systemic therapy for brain metastases, extending survival, and putting them at risk for fRNB. Currently, treatment options are limited to long-term corticosteroid therapy, which has significant side effects, or surgery with its inherent risks. Bevacizumab, a monoclonal antibody that targets the vascular endothelial growth (VEGF), is effective in treating fRNB but its use has remained limited due to its cost. In this single-center case series, a fixed low dose of bevacizumab (400 mg loading dose followed by 100 mg every 4 weeks) was shown to be a safe and cost-effective alternative treatment option for fRNB. Abstract Focal radiation necrosis of the brain (fRNB) is a late adverse event that can occur following the treatment of benign or malignant brain lesions with stereotactic radiation therapy (SRT) or stereotactic radiosurgery (SRS). Recent studies have shown that the incidence of fRNB is higher in cancer patients who received immune checkpoint inhibitors. The use of bevacizumab (BEV), a monoclonal antibody that targets the vascular endothelial growth factor (VEGF), is an effective treatment for fRNB when given at a dose of 5–7.5 mg/kg every two weeks. In this…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 13 participants or records.
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