Activity of VEGF inhibition for the treatment of POEMS syndrome
| Treatment . | Outcome . |
|---|---|
| Bev alone21 | Death within 6 wks |
| Bev + mycophenolate + Dex97 | One mo after starting therapy, patient deteriorated further with worsening ascites and shortness of breath; Bev and Dex were discontinued; Mel and Pred were begun; patient died 1 mo later |
| Bev alone22 | Worsening PN, anasarca, multiorgan failure; died of pneumonia 5 wks after therapy |
| Bev alone23 | Improved pain, breathing, and walking |
| Bev + Mel-Dex24 | Improved effusions/ascites |
| Prior VAD/CTX25 | Improved edema, pain, weakness, and VEGF |
| Bev + CTX-Dex26 | Initial worsening; repeat with Bev → improved pulmonary HTN, anasarca, skin changes |
| Bev + CTX-CS27 | Initial improvement, but multiorgan failure and death |
| Bev + CTX radiation29 | Two patients: (1) first patient treated with radiation and CTX and then Bev; clinical improvement started before Bev; at radiologic relapse, Bev no use, so Len plus Dex used with benefit; and (2) second patient treated with same sequence, but course complicated by sepsis; biochemical and early neurologic response before Bev started |
| Bev + CTX28 | Clinical and biochemical relapse; no response to CTX, so bevacizumab added; death |
| Treatment . | Outcome . |
|---|---|
| Bev alone21 | Death within 6 wks |
| Bev + mycophenolate + Dex97 | One mo after starting therapy, patient deteriorated further with worsening ascites and shortness of breath; Bev and Dex were discontinued; Mel and Pred were begun; patient died 1 mo later |
| Bev alone22 | Worsening PN, anasarca, multiorgan failure; died of pneumonia 5 wks after therapy |
| Bev alone23 | Improved pain, breathing, and walking |
| Bev + Mel-Dex24 | Improved effusions/ascites |
| Prior VAD/CTX25 | Improved edema, pain, weakness, and VEGF |
| Bev + CTX-Dex26 | Initial worsening; repeat with Bev → improved pulmonary HTN, anasarca, skin changes |
| Bev + CTX-CS27 | Initial improvement, but multiorgan failure and death |
| Bev + CTX radiation29 | Two patients: (1) first patient treated with radiation and CTX and then Bev; clinical improvement started before Bev; at radiologic relapse, Bev no use, so Len plus Dex used with benefit; and (2) second patient treated with same sequence, but course complicated by sepsis; biochemical and early neurologic response before Bev started |
| Bev + CTX28 | Clinical and biochemical relapse; no response to CTX, so bevacizumab added; death |
Bev indicates bevacizumab; Dex, dexamethasone; Mel, mephalan; Pred, prednisone; PN, polyneuropathy; VAD, vincristine, doxorubicin, dexamethasone; CTX, cyclophosphamide; HTN, hypertension; CS, corticosteroids; and Len, lenalidomide.