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Treatment of adult brainstem glioma with combined antiangiogenic therapy: a case report and literature review

Authors Yu D, Han G, Liu H, Gao L, Verma V

Received 23 November 2018

Accepted for publication 24 January 2019

Published 18 February 2019 Volume 2019:12 Pages 1333—1339

DOI https://doi.org/10.2147/OTT.S195783

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 3

Editor who approved publication: Dr Carlos E Vigil


Dongdong Yu,1 Guang Han,2 Huali Liu,3 Likun Gao,4 Vivek Verma5

1Department of Radiation Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, P.R. China; 2Department of Radiation Oncology, Hubei Cancer Hospital, Wuhan, Hubei Province, P.R. China; 3Department of Oncology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, P.R. China; 4Department of Pathology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, P.R. China; 5Department of Radiation Oncology, Allegheny General Hospital, Pittsburgh, PA, USA

Abstract: Adult brainstem gliomas belong to a rare and heterogeneous group of brain tumors. The overall prognosis is poor; therapeutic options are limited, given the resistance to radiotherapy and the unclear role of chemotherapy/antiangiogenic therapy. Apatinib, a tyrosine kinase inhibitor that selectively inhibits the vascular endothelial growth factor receptor and mildly inhibits c-Kit, PDGFR-β, RET, and c-SRC, has been reported to show efficacy among some patients with malignant supratentorial gliomas. However, its effect on brainstem glioma has not been reported so far. Herein, a 66-year-old man with brainstem anaplastic astrocytoma isocitrate dehydrogenase (IDH) wild type was treated initially with combined radiotherapy, temozolomide, and apatinib. The patient achieved a complete response by MRI and continues to have an ongoing progression-free survival of over 8 months. To our knowledge, this is the first case report using apatinib to treat brainstem IDH wild-type anaplastic astrocytoma, displaying an excellent outcome. We also summarize cases of adult brainstem glioma treated with antiangiogenic therapy. Experiences using various regimens may improve understanding of this rare disease, and thus help physicians to seek more effective treatments for these patients.

Keywords: VEGFR, antiangiogenic therapy, apatinib, brainstem glioma
 

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