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Purpose <p>NF2-related schwannomatosis (NF2) patients are predisposed to develop multiple peripheral and central nervous tumors including bilateral vestibular schwannomas (VS). Decision on patient management, especially in large growing tumors, might be challenging concerning possible treatment-related complications and quality of life. Systemic therapy with bevacizumab has been reported to slow VS growth and improve hearing. Here, we present single-center outcomes of NF2 patients treated with bevacizumab.</p> Methods <p>We conducted a retrospective analysis of 15 NF2 patients with morphologically diagnosed unilateral or bilateral VS indicated for systemic therapy with bevacizumab (5&#xa0;mg/kg every 2 weeks) in 2015–2022. Tumor growth rate, volume, and hearing thresholds were assessed before, during, and after first-line bevacizumab therapy.</p> Results <p>15 patients (5 male, 10 females, mean age at the start of the therapy 30y, mean no. of bevacizumab cycles 35) and 25 tumors were evaluated. Radiologically significant (&gt; 20% from the baseline) tumor volume reduction was observed in 5 patients. Notably, in patients with bilateral VS, volume reduction occurred on only one side. Three patients demonstrated a significantly reduced growth rate and tumor stabilization. Hearing improvement was documented in 1 patient, while another experienced significant hearing decline.</p> Conclusion <p>Bevacizumab therapy may contribute to tumor shrinkage and hearing stabilization in NF2 patients. However, treatment response is variable, with meaningful tumor reduction and hearing improvement observed only in a minority of cases.</p>

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Efficacy of first line of bevacizumab in patients with neurofibromatosis 2-related vestibular schwannomas

  • 期刊论文

  • 发表日期：

    2025年10月6日

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  • Vladimír Koucký,
  • Michaela Jirkovská,
  • Aleš Vlasák,
  • Lenka Kinštová,
  • Jan Lazák,
  • Eduard Zveřina,
  • Jan Betka,
  • Bořivoj Petrák,
  • Pavel Tesner,
  • Emilie Vyhnálková,
  • Zdeněk Fík

摘要

Purpose

NF2-related schwannomatosis (NF2) patients are predisposed to develop multiple peripheral and central nervous tumors including bilateral vestibular schwannomas (VS). Decision on patient management, especially in large growing tumors, might be challenging concerning possible treatment-related complications and quality of life. Systemic therapy with bevacizumab has been reported to slow VS growth and improve hearing. Here, we present single-center outcomes of NF2 patients treated with bevacizumab.

Methods

We conducted a retrospective analysis of 15 NF2 patients with morphologically diagnosed unilateral or bilateral VS indicated for systemic therapy with bevacizumab (5 mg/kg every 2 weeks) in 2015–2022. Tumor growth rate, volume, and hearing thresholds were assessed before, during, and after first-line bevacizumab therapy.

Results

15 patients (5 male, 10 females, mean age at the start of the therapy 30y, mean no. of bevacizumab cycles 35) and 25 tumors were evaluated. Radiologically significant (> 20% from the baseline) tumor volume reduction was observed in 5 patients. Notably, in patients with bilateral VS, volume reduction occurred on only one side. Three patients demonstrated a significantly reduced growth rate and tumor stabilization. Hearing improvement was documented in 1 patient, while another experienced significant hearing decline.

Conclusion

Bevacizumab therapy may contribute to tumor shrinkage and hearing stabilization in NF2 patients. However, treatment response is variable, with meaningful tumor reduction and hearing improvement observed only in a minority of cases.