Bevacizumab for Hearing Preservation in Neurofibromatosis Type 2

Emphasis on Patient-Reported Outcomes and Toxicities

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance. Volumetric analysis of serial magnetic resonance imaging scans was used to evaluate radiographic response, and hearing response was evaluated with serial audiograms. Patient-reported outcomes were also assessed, including subjective hearing improvement, changes in tinnitus, vertigo, headaches, ear pain, and improvement in ability to communicate via telephone. Results: A positive radiographic response occurred in 8 of 17 (47%) patients and the median tumor volume change was a tumor decrease of 19%. A positive hearing response was recorded in 5 of 9 (56%) patients. Two patients had a word recognition score improvement over 40%. There was an approximately 40% improvement in patient-reported outcomes. Primary toxicities included hypertension, proteinuria, dysgeusia, and amenorrhea. Conclusion: Bevacizumab treatment was followed by hearing improvement in 56% of patients, while decreased tumor volume was noted in 47%. These outcomes agree favorably with prior reported series. There were significant improvements in patient-reported outcomes that have not been described previously.

Original languageEnglish (US)
Pages (from-to)526-532
Number of pages7
JournalOtolaryngology - Head and Neck Surgery (United States)
Volume160
Issue number3
DOIs
StatePublished - Mar 1 2019

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Neurofibromatosis 2
Hearing
Tumor Burden
Dysgeusia
Aptitude
Acoustic Neuroma
Cochlear Implants
Tinnitus
Patient Reported Outcome Measures
Bevacizumab
Vertigo
Amenorrhea
Proteinuria
Telephone
Tertiary Care Centers
Ear
Headache
Magnetic Resonance Imaging
Hypertension
Pain

Keywords

  • NF2
  • bevacizumab
  • neurofibromatosis type 2
  • patient-reported outcomes
  • vestibular schwannoma

Cite this

@article{6e9e9e22e85743eca117c59043c68388,
title = "Bevacizumab for Hearing Preservation in Neurofibromatosis Type 2: Emphasis on Patient-Reported Outcomes and Toxicities",
abstract = "Objective: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance. Volumetric analysis of serial magnetic resonance imaging scans was used to evaluate radiographic response, and hearing response was evaluated with serial audiograms. Patient-reported outcomes were also assessed, including subjective hearing improvement, changes in tinnitus, vertigo, headaches, ear pain, and improvement in ability to communicate via telephone. Results: A positive radiographic response occurred in 8 of 17 (47{\%}) patients and the median tumor volume change was a tumor decrease of 19{\%}. A positive hearing response was recorded in 5 of 9 (56{\%}) patients. Two patients had a word recognition score improvement over 40{\%}. There was an approximately 40{\%} improvement in patient-reported outcomes. Primary toxicities included hypertension, proteinuria, dysgeusia, and amenorrhea. Conclusion: Bevacizumab treatment was followed by hearing improvement in 56{\%} of patients, while decreased tumor volume was noted in 47{\%}. These outcomes agree favorably with prior reported series. There were significant improvements in patient-reported outcomes that have not been described previously.",
keywords = "NF2, bevacizumab, neurofibromatosis type 2, patient-reported outcomes, vestibular schwannoma",
author = "Pavlina Sverak and Adams, {Meredith E} and Haines, {Stephen J} and Levine, {Samuel C} and Nascene, {David R} and Katherine Sommer and Dusenbery, {Kathryn E} and Huang, {Tina C} and Moertel, {Christopher L}",
year = "2019",
month = "3",
day = "1",
doi = "10.1177/0194599818809085",
language = "English (US)",
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T1 - Bevacizumab for Hearing Preservation in Neurofibromatosis Type 2

T2 - Emphasis on Patient-Reported Outcomes and Toxicities

AU - Sverak, Pavlina

AU - Adams, Meredith E

AU - Haines, Stephen J

AU - Levine, Samuel C

AU - Nascene, David R

AU - Sommer, Katherine

AU - Dusenbery, Kathryn E

AU - Huang, Tina C

AU - Moertel, Christopher L

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Objective: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance. Volumetric analysis of serial magnetic resonance imaging scans was used to evaluate radiographic response, and hearing response was evaluated with serial audiograms. Patient-reported outcomes were also assessed, including subjective hearing improvement, changes in tinnitus, vertigo, headaches, ear pain, and improvement in ability to communicate via telephone. Results: A positive radiographic response occurred in 8 of 17 (47%) patients and the median tumor volume change was a tumor decrease of 19%. A positive hearing response was recorded in 5 of 9 (56%) patients. Two patients had a word recognition score improvement over 40%. There was an approximately 40% improvement in patient-reported outcomes. Primary toxicities included hypertension, proteinuria, dysgeusia, and amenorrhea. Conclusion: Bevacizumab treatment was followed by hearing improvement in 56% of patients, while decreased tumor volume was noted in 47%. These outcomes agree favorably with prior reported series. There were significant improvements in patient-reported outcomes that have not been described previously.

AB - Objective: Bevacizumab for hearing preservation in patients with neurofibromatosis type 2 (NF2) is an emerging practice. We set out to characterize the effectiveness and toxicity of bevacizumab in our patient group. Study Design: Case series with chart review. Setting: Tertiary referral center. Subjects and Methods: Seventeen consecutive patients with NF2 received bevacizumab treatment for vestibular schwannomas, including 2 patients treated to maintain cochlear implant performance. Volumetric analysis of serial magnetic resonance imaging scans was used to evaluate radiographic response, and hearing response was evaluated with serial audiograms. Patient-reported outcomes were also assessed, including subjective hearing improvement, changes in tinnitus, vertigo, headaches, ear pain, and improvement in ability to communicate via telephone. Results: A positive radiographic response occurred in 8 of 17 (47%) patients and the median tumor volume change was a tumor decrease of 19%. A positive hearing response was recorded in 5 of 9 (56%) patients. Two patients had a word recognition score improvement over 40%. There was an approximately 40% improvement in patient-reported outcomes. Primary toxicities included hypertension, proteinuria, dysgeusia, and amenorrhea. Conclusion: Bevacizumab treatment was followed by hearing improvement in 56% of patients, while decreased tumor volume was noted in 47%. These outcomes agree favorably with prior reported series. There were significant improvements in patient-reported outcomes that have not been described previously.

KW - NF2

KW - bevacizumab

KW - neurofibromatosis type 2

KW - patient-reported outcomes

KW - vestibular schwannoma

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