From the Guidelines
Radiation therapy can be administered concurrently with Bevacizumab, but it is not recommended as a standard treatment due to the lack of overall survival benefit and increased risk of adverse events. The use of Bevacizumab with radiation therapy is generally not advised, as evidenced by the American Society of Clinical Oncology (ASCO) guideline endorsement of the American Society for Radiation Oncology guideline, which states that the addition of Bevacizumab to standard therapy for newly diagnosed glioblastoma does not improve overall survival and is associated with a higher incidence of early adverse events 1.
When considering the use of Bevacizumab with radiation therapy, it is essential to weigh the potential benefits against the risks, including increased toxicities such as radiation necrosis, delayed wound healing, and bleeding. The standard Bevacizumab dosing (typically 5-15 mg/kg every 2-3 weeks depending on the cancer type) may need to be adjusted based on individual patient assessment.
Some key points to consider when evaluating the use of Bevacizumab with radiation therapy include:
- The ASCO guideline recommends against the routine addition of Bevacizumab to standard therapy for newly diagnosed glioblastoma outside a clinical trial 1
- The combination of Bevacizumab and radiation therapy may be used in certain situations, such as in clinical trials or for patients with specific types of cancer, but careful monitoring and individualized assessment are necessary
- The use of Bevacizumab with radiation therapy requires careful consideration of the potential risks and benefits, including the impact on overall survival, progression-free survival, and quality of life 1
In summary, while radiation therapy can be administered concurrently with Bevacizumab, the current evidence does not support its use as a standard treatment due to the lack of overall survival benefit and increased risk of adverse events. The decision to use Bevacizumab with radiation therapy should be made on a case-by-case basis, taking into account the individual patient's characteristics, cancer type, and potential risks and benefits.
From the Research
Administration of Radiation Therapy with Bevacizumab
- Radiation therapy can be administered concurrently with Bevacizumab, as shown in several studies 2, 3, 4, 5, 6.
- The combination of Bevacizumab with radiation therapy and temozolomide has been investigated in various clinical trials for the treatment of newly diagnosed glioblastoma 2, 5, 6.
- These studies have demonstrated that the addition of Bevacizumab to standard radiation therapy and temozolomide is safe and effective, with moderate toxicity 2, 4, 5.
- The results from these studies suggest that Bevacizumab may improve efficacy compared to historical controls, although further research is needed to confirm this 2, 3, 5.
Safety and Toxicity
- The safety profile of Bevacizumab in combination with radiation therapy and temozolomide has been evaluated in several studies 4, 5, 6.
- Common toxicities associated with this combination include hypertension, proteinuria, and thrombocytopenia 4, 5.
- Severe toxicities, such as arterial thromboembolic events and cerebral hemorrhage, have also been reported, although these are rare 4.
- The incidence of adverse events has been shown to be higher in patients treated with Bevacizumab compared to those receiving placebo 4.
Efficacy
- The efficacy of Bevacizumab in combination with radiation therapy and temozolomide has been evaluated in terms of overall survival and progression-free survival 2, 5, 6.
- The results from these studies have shown that the addition of Bevacizumab to standard radiation therapy and temozolomide may improve progression-free survival, although the impact on overall survival is less clear 2, 5, 6.
- Further research is needed to fully understand the efficacy of this combination and to determine its potential benefits in the treatment of newly diagnosed glioblastoma 2, 3, 5.