Yi Li MD, Presenter: Nothing to Disclose

Saad Shahid Ali MD, Abstract Co-Author: Nothing to Disclose

Jennifer Clarke MD, MPH, Abstract Co-Author: Nothing to Disclose

Soonmee Cha MD, Abstract Co-Author: Nothing to Disclose

1. Bevacizumab blocks the action of vascular endothelial growth factor, and is used in the treatment of recurrent glioblastoma. 2. Response to Bevacizumab is indicated by marked decrease in enhancement and decrease in vasogenic edema. 3. The purpose of this educational exhibit is to demonstrate four main patterns of Bevacizumab failure described in the literature and associated non-neoplastic complications following therapy. After describing these patterns, we will present cases in quiz format to reinforce the major teaching points.

1. Bevacizumab in the treatment of recurrent glioma - Mechanism of action and evidence behind Bevacizumab therapy - Patterns of treatment response 2. Four main patterns of Bevacizumab failure have been identified in the literature: - Pattern 1: Local tumor progression with increasing FLAIR abnormality, but without enhancement - Pattern 2: Diffuse tumor infiltration in a gliomatosis-like pattern, with minimal enhancement - Pattern 3: Improvement in local tumor, but development of new distant unifocal or multifocal enhancing tumor - Pattern 4: Continued progression of local or multifocal disease with increase in FLAIR and enhancement 3. Several complications of Bevacizumab therapy have been seen: - Diffusion abnormality: ischemic injury or hypoxic/hypercellular tumor - Hemorrhage

http://abstract.rsna.org/uploads/2014/14005408/14005408_3d2v.pdf

Li, Y, Ali, S, Clarke, J, Cha, S, Bevacizumab in Recurrent Glioma: Patterns of Treatment Failure and Complications.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14005408.html