BEVACIZUMAB-CONTAINING TREATMENT for RELAPSED or REFRACTORY WILMS TUMOR.

Angiogenesis is critical for tumor growth and metastasis. Bevacizumab is an antiangiogenic drug used to treat various adult and childhood solid tumors. Its potential efficacy in Wilms tumor (WT) with poor prognosis is not established. The response to bevacizumab-containing regimens in relapsed or refractory WT was reviewed in available literature. Searches were conducted using Pubmed, Scopus and ClinicalTrials.gov databases. Eight papers were identified, published between 2007 and 2020 including 6 treatment regimens, predominantly vincristine, irinotecan and bevacizumab (VIB) ± temozolomide (VITB). Among 16 evaluable patients, there were two complete responses, 7 partial responses, 5 patients achieved stable disease (SD) and two patients had progressive disease. Objective responses (OR) were observed in 56% of all cases. OR or SD was observed in 89% (8/9) patients who received VIB/VITB. Bevacizumab was generally well tolerated. Related toxicities included hypertension, proteinuria and delayed wound healing. This review suggests potential effectiveness and good tolerability of bevacizumab in the setting of relapsed/refractory WT when used in combination with other drugs. Such combination therapies may serve as a bridging treatment option to other interventions and more personalized treatment options in the future, however focused trials are needed to obtain additional evidence.