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Antiangiogenic Therapies and Extracranial Metastasis in Glioblastoma: A Case Report and Review of the Literature.

Khattab MH, Marciscano AE, Lo SS, Lim M, Laterra JJ, Kleinberg LR, Redmond KJ - Case Rep Oncol Med (2015)

Bottom Line: We present a case report of a patient with glioblastoma multiforme (GBM) complicated by extracranial metastasis (ECM) whose survival of nearly four years surpassed the anticipated life expectancy given numerous negative prognostic factors including EGFRvIII-mutation, unmethylated MGMT promoter status, and ECM.Interestingly, while this patient suffered from locally aggressive disease with multiple intracranial recurrences, the proximal cause of death was progressive extracranial disease and complications related to pulmonary metastases.Herein, we review potential mechanisms of ECM with an emphasis upon glioblastoma molecular and genetic profiles and the potential implications of targeted agents such as bevacizumab.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, 401 North Broadway, Suite 1440, Baltimore, MD 21231-5678, USA.

ABSTRACT
We present a case report of a patient with glioblastoma multiforme (GBM) complicated by extracranial metastasis (ECM) whose survival of nearly four years surpassed the anticipated life expectancy given numerous negative prognostic factors including EGFRvIII-mutation, unmethylated MGMT promoter status, and ECM. Interestingly, while this patient suffered from locally aggressive disease with multiple intracranial recurrences, the proximal cause of death was progressive extracranial disease and complications related to pulmonary metastases. Herein, we review potential mechanisms of ECM with an emphasis upon glioblastoma molecular and genetic profiles and the potential implications of targeted agents such as bevacizumab.

No MeSH data available.


Related in: MedlinePlus

Intracranial imaging during final course of salvage therapy with bevacizumab and carboplatin. (a) FLAIR, (b) T1-weighted axial, and (c) T2-weighted axial magnetic resonance imaging demonstrating stable intracranial disease at time of respiratory decline. Postsurgical hyperintensity surrounds area of resection in the right temporal and occipital lobes communicating with the right occipital horn, unchanged with respect to prior imaging.
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fig3: Intracranial imaging during final course of salvage therapy with bevacizumab and carboplatin. (a) FLAIR, (b) T1-weighted axial, and (c) T2-weighted axial magnetic resonance imaging demonstrating stable intracranial disease at time of respiratory decline. Postsurgical hyperintensity surrounds area of resection in the right temporal and occipital lobes communicating with the right occipital horn, unchanged with respect to prior imaging.

Mentions: One month later, he resumed treatment with bevacizumab and, in the 43rd month, carboplatin. Restaging FDG PET imaging after 2 cycles revealed extracranial progression of disease with worsening pulmonary and skeletal metastases. Of note, synchronous brain MRI was stable at this time with no evidence of intracranial recurrence or progression (Figure 3). He continued with a third and final cycle of concurrent bevacizumab and carboplatin with continued decline of his respiratory status. 46 months from initial diagnosis, he ultimately passed away secondary to acute respiratory failure. At the time of his death, there was no clinical or radiographic evidence of disease within the central nervous system.


Antiangiogenic Therapies and Extracranial Metastasis in Glioblastoma: A Case Report and Review of the Literature.

Khattab MH, Marciscano AE, Lo SS, Lim M, Laterra JJ, Kleinberg LR, Redmond KJ - Case Rep Oncol Med (2015)

Intracranial imaging during final course of salvage therapy with bevacizumab and carboplatin. (a) FLAIR, (b) T1-weighted axial, and (c) T2-weighted axial magnetic resonance imaging demonstrating stable intracranial disease at time of respiratory decline. Postsurgical hyperintensity surrounds area of resection in the right temporal and occipital lobes communicating with the right occipital horn, unchanged with respect to prior imaging.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493308&req=5

fig3: Intracranial imaging during final course of salvage therapy with bevacizumab and carboplatin. (a) FLAIR, (b) T1-weighted axial, and (c) T2-weighted axial magnetic resonance imaging demonstrating stable intracranial disease at time of respiratory decline. Postsurgical hyperintensity surrounds area of resection in the right temporal and occipital lobes communicating with the right occipital horn, unchanged with respect to prior imaging.
Mentions: One month later, he resumed treatment with bevacizumab and, in the 43rd month, carboplatin. Restaging FDG PET imaging after 2 cycles revealed extracranial progression of disease with worsening pulmonary and skeletal metastases. Of note, synchronous brain MRI was stable at this time with no evidence of intracranial recurrence or progression (Figure 3). He continued with a third and final cycle of concurrent bevacizumab and carboplatin with continued decline of his respiratory status. 46 months from initial diagnosis, he ultimately passed away secondary to acute respiratory failure. At the time of his death, there was no clinical or radiographic evidence of disease within the central nervous system.

Bottom Line: We present a case report of a patient with glioblastoma multiforme (GBM) complicated by extracranial metastasis (ECM) whose survival of nearly four years surpassed the anticipated life expectancy given numerous negative prognostic factors including EGFRvIII-mutation, unmethylated MGMT promoter status, and ECM.Interestingly, while this patient suffered from locally aggressive disease with multiple intracranial recurrences, the proximal cause of death was progressive extracranial disease and complications related to pulmonary metastases.Herein, we review potential mechanisms of ECM with an emphasis upon glioblastoma molecular and genetic profiles and the potential implications of targeted agents such as bevacizumab.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology & Molecular Radiation Sciences, Johns Hopkins University, 401 North Broadway, Suite 1440, Baltimore, MD 21231-5678, USA.

ABSTRACT
We present a case report of a patient with glioblastoma multiforme (GBM) complicated by extracranial metastasis (ECM) whose survival of nearly four years surpassed the anticipated life expectancy given numerous negative prognostic factors including EGFRvIII-mutation, unmethylated MGMT promoter status, and ECM. Interestingly, while this patient suffered from locally aggressive disease with multiple intracranial recurrences, the proximal cause of death was progressive extracranial disease and complications related to pulmonary metastases. Herein, we review potential mechanisms of ECM with an emphasis upon glioblastoma molecular and genetic profiles and the potential implications of targeted agents such as bevacizumab.

No MeSH data available.


Related in: MedlinePlus