BACKGROUND: The authors evaluated a 3-week schedule of bevacizumab in patients 
with recurrent high-grade glioma (HGG).
METHODS: Patients received bevacizumab 15 mg/kg every 3 weeks and were evaluated 
every 6 weeks until tumor progression. Tissue correlates were used to quantify 
tumor content of vascular endothelial growth factor A (VEGFA) and vascular 
endothelial growth factor receptor-2 (VEGFR2).
RESULTS: Of 61 patients who were treated (35 men and 26 women; median age, 52 
years; age range, 21-78 years), 50 patients had glioblastoma multiforme (GBM), 
and 11 patients had anaplastic glioma (AG). The median number of previous 
chemotherapies was 2 (range, 1-5 previous chemotherapies), and 16 patients had 
received ≥3 previous chemotherapies. The median number of bevacizumab doses was 
4 (range, 1-20 doses), and 45% of patients received >5 doses. The toxicities 
observed were primarily grade 1 and 2, and the most common were fatigue, 
hypertension, and headache. One grade 2 intratumoral bleed and 1 bowel 
perforation were reported. For patients with GBM, the 6-month progression-free 
survival rate was 25%, the median time to tumor progression was 10.8 weeks, and 
the median overall survival was 25.6 weeks. The best response included a partial 
response in 15 patients (24.5%) and stable disease in 31 patients (50.8%) 
patients; radiographic recurrence patterns included increased changes in fluid 
attenuation inversion recovery (24%) and multifocal recurrence (20%). The median 
survival after bevacizumab failure was 10 weeks. The ratio of tumor VEGFA/VEGFR2 
was increased in patients aged >55 years; an increased VEGFA/VEGFR2 ratio was 
correlated nonsignificantly with decreased survival (P = .052).
CONCLUSIONS: An every-3-week schedule of bevacizumab had antitumor activity and 
was relatively nontoxic for patients with recurrent HGG. The predictive value of 
VEGFA/VEGFR2 in tumor will require validation in a larger patient cohort.