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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Recursive GBM, Tumor Recurred Post Chemo, Operation Done. Best Advanced Options For Treatment?

Hello Doctor, My husband [age 32] is a recursive GBM patient and undergone surgery twice [sep-2011 and dec-2012] After the 1st surgery he has undergone - 2 sets of Cyberknife and IGRT radiotherapy , followed by a 9 cycles of oral cheamotherapy [temozolamide] After the 9 cycles of cheamo -within two months tumor got reoccured and he has been operated and removed the tumor.. Now, can you please guide me - what are the next best advanced available options to treat him , so that we can get the best results out of that? the options that we are hearing are the followings in the priority: 1. irenotic + Avastin -- IV fluids cheamo 2.Teamozolamide oral Please help us by guiding - any advanced options and what are the pro s and con s for the same... Please let me know if you need any more information on the same... i can provide the same.. Thanks for your time..
Tue, 3 Sep 2013
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Oncologist,  's  Response
In case of recurrent GBM tas in the case of your husband the best option is the drug Avastin administered at a dose of 10mg/kg intravenous every 2 weeks.
The main side effect of avastin is hypertension and proteinuria for which dose reductions may be required.
When Avastin is given in combination with another drug irinotecan the dose of avastin remains the same and irinotecan is dosed at 340 mg/m2 for patients on enzyme inducing anticonvulsants and 125 mg/m2 for patients not on enzyme inducing anticonvulsants.
Both the drugs are dissolved in IV fluid and administered over 1 hr over vein.
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Recursive GBM, Tumor Recurred Post Chemo, Operation Done. Best Advanced Options For Treatment?

In case of recurrent GBM tas in the case of your husband the best option is the drug Avastin administered at a dose of 10mg/kg intravenous every 2 weeks. The main side effect of avastin is hypertension and proteinuria for which dose reductions may be required. When Avastin is given in combination with another drug irinotecan the dose of avastin remains the same and irinotecan is dosed at 340 mg/m2 for patients on enzyme inducing anticonvulsants and 125 mg/m2 for patients not on enzyme inducing anticonvulsants. Both the drugs are dissolved in IV fluid and administered over 1 hr over vein.