Eight-year survival of a recurrent glioblastoma patient treated with molecularly tailored therapy: a case report.
Quintino Giorgio D'AlessandrisNicola MontanoMaurizio MartiniTonia CenciLiverana LaurettiVittorio StumpoFabrizio PignottiAlessandro OliviEduardo FernandezLuigi Maria LaroccaRoberto PalliniPublished in: Acta neurochirurgica (2018)
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.
Keyphrases
- free survival
- vascular endothelial growth factor
- endothelial cells
- newly diagnosed
- cell proliferation
- end stage renal disease
- chronic kidney disease
- smoking cessation
- prognostic factors
- stem cells
- case report
- health insurance
- advanced non small cell lung cancer
- bone marrow
- patient reported outcomes
- combination therapy
- tyrosine kinase
- metastatic colorectal cancer
- affordable care act