Abigail Koehler1, Yehudit Rothman1*, Justin Gibson2*, Michelle Kirschner3, Brandi Turner4, Mahmoud Charif5, Abdelkader Mahammedi6, Jonathan Forbes2 and Soma Sengupta1
1Department of Neurology & Rehabilitation Medicine, University of Cincinnati, USA
2Department of Neurosurgery, University of Cincinnati, USA
3Department of Family Medicine, University of Cincinnati, USA
4The Barrett Cancer Center, University of Cincinnati, USA
5Division of Hematology & Oncology, University of Cincinnati, USA
6Department of Neuroradiology, University of Cincinnati, USA
Following Glioblastoma Multiforme (GBM) diagnosis, patients typically undergo surgical resection, followed by radiation with concurrent Temozolomide (TMZ) per the Stupp protocol as the standard-of-care. A 58-year old female patient at our institution, originally diagnosed with ER+, PR+, HER2+ Stage IB breast cancer, was later found to have a GBM tumor crossing the corpus
callosum 6-months after completing radiotherapy for her breast cancer diagnosis. The patient was unable to tolerate TMZ due to persistent pancytopenia. Her White Blood Cell (WBC) count nadir was 400/mm3 and her platelet count nadir was 11,000/L. The patient was started on Bevacizumab (brand name: Avastin) in combination with an Optune device following the completion of brain
radiation treatment and retainment of normal blood cell counts. Her blood counts continued to remain normal; WBC counts ranging from 2,900 to 4,600/mm3 and platelet counts ranging from 121,000 to 213,000/L while undergoing Avastin chemotherapy paired with the Optune device. The patient’s imaging remains stable with a measurable mass of 5.7 cm × 3.2 cm × 5.5 cm compared to the 6.5 cm × 4.3 cm × 6.5 cm size of the mass at diagnosis. We propose this combination of therapy
may useful upfront for patients diagnosed with large GBM tumors or GBM tumors that cannot be resected who cannot tolerate TMZ due to allergy or adverse reactions.
Koehler A, Rothman Y, Gibson J, Kirschner M, Turner B, Charif M, et al. Bevacizumab and Optune Combination in Treating Newly Diagnosed GBM: Case Study. Clin Oncol. 2020; 5: 1752..