Ni-10 clinical benefits from one-shot bevacizumab before a resection of glioblastoma

Abstract Purpose We aimed to clarify of clinical impacts from preoperative administration of bevacizumab (BEV) in patients with newly diagnosed glioblastoma. Methods Subjects were 17 patients who met the entry criteria, and were administered with BEV (10 mg/kg) one time before surgery. Between phases before and after BEV administration, we compared KPS and volumes of hyperintense areas on FLAIR and enhanced areas on T1-weighted imaging with contrast media (Gd-T1WI). Tumor resection was carried out at least three weeks after BEV. Also between phases immediately before and after operation, volumes of hyperintense areas on FLAIR and enhanced areas on Gd-T1WI (= tumor removal rate) were compared. These were compared with those in the control group of patients who received tumor resection without BEV. Results One-shot BEV led to significant improvement of KPS and significant volume reductions of hyperintense areas on FLAIR (43.8±26.3%) and enhanced areas on Gd-T1WI (34.6±18.2%). No patients showed any adverse effects around surgery. On MRI after surgery, volume-reduction rates of hyperintense areas on FLAIR and enhanced areas on Gd-T1WI were 44.7±24.7% and 96.2±5.4%, respectively. Compared with control group, a significant difference was identified in the reduction rate of hyperintense areas, but not in that of enhanced areas. Conclusions One-shot administration with BEV reduced both volumes of hyperintense areas on FLAIR and enhanced areas on Gd-T1WI, thereby improved KPS before surgery. Preoperative BEV was safe for tumor resections but did not affect to tumor removal rate. We speculated a significant volume reduction of hyperintense areas on FLAIR might have been led by continuous effect from BEV rather than an increase of resected volume.