The HERBY study: A phase II open label, randomized, multicenter, comparative study of bevacizumab (Bv)-based therapy in pediatric patients with newly diagnosed supratentorial high-grade glioma (HGG).

Pediatric Oncology
Session Type and Session Title: 
General Poster Session, Pediatric Oncology
Abstract Number: 


J Clin Oncol 30, 2012 (suppl; abstr TPS9596)
Jacques Grill, Darren R Hargrave, Pascale Varlet, Tim Jaspan, Chris Jones, Maura Massimino, Adela Cañete, Amedeo A. Azizi, Marie-Cécile Le Deley, Frank Saran, Paul Morgan, Gudrun Zahlmann, Louis Viviers, Jeanette Bachir, Aijing Shang, Raphael F. Rousseau, Gilles Vassal, on behalf of the European Innovative Therapies for Children with Cancer (ITCC) Consortium, The SIOP-E Brain Tumour Group and the Australian Children's Cancer Trials Group; Institut Gustave Roussy, Villejuif, France; Great Ormond Street Hospital, London, United Kingdom; Sainte-Anne Hospital, Paris, France; University Hospital, Nottingham, United Kingdom; Institute of Cancer Research, Sutton, United Kingdom; Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy; H.U. LA FE, Valencia, Spain; Univ. Klinik für Kinder und Jugendheilkunde, Vienna, Austria; Royal Marsden NHS Trust, Sutton, United Kingdom; Nottingham University Hospitals, Nottingham, United Kingdom; F. Hoffmann-La Roche Ltd., Basel, Switzerland

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Abstract Disclosures


Background: Despite therapeutic advances, outcomes in pediatric HGG remain poor. The phase I study (Glade-Bender et al., J Clin Oncol. 2008) indicated that Bv is well tolerated in children with refractory solid tumors and yielded pharmacokinetic (PK) data that support further studies of Bv in childhood cancer. Reports of Bv used in children with solid tumors showed safety profiles consistent with data from adults. Methods: 120 evaluable patients aged 3-18 years with newly diagnosed histologically confirmed WHO grade 3or 4 HGG are randomized to receive standard combined modality therapy as currently adopted worldwide by the pediatric neuro-oncology community with or without Bv. Treatment consists of 6 weeks of concomitant TMZ and local radiotherapy, followed by a 4-week TMZ treatment break and 48 weeks of adjuvant TMZ with or without Bv every other week. Primary endpoint is event-free survival (EFS). Progression is based on RANO criteria. Secondary endpoints are overall survival (OS), safety, feasibility, and tolerability. PK sampling is performed during cycles 1-4 of the adjuvant TMZ phase on all patients randomized to receive Bv. Health-related quality of life, neurocognitive functions, MGMT methylation status, functional changes in tumor based on magnetic resonance diffusion & perfusion imaging and spectroscopy are explored as well as the correlation of biomarkers with clinical activity and adverse events. All randomized patients will be followed for at least 3 years. Analysis of EFS and secondary endpoints will be performed after the 120 patients evaluable for EFS have been followed for 1 year. Multimodal imaging will provide a platform to develop new imaging criteria for pediatric neuro-oncological treatment response. An updated OS and safety analysis will be performed 3 years after the last patient has been randomized. The first patient was randomized in October 2011; completion of the study is expected in 2016.