Integrated analysis of long‐term growth and bone development in pediatric and adolescent patients receiving bevacizumab

Background We conducted an integrated analysis of clinical data to describe long‐term effects of bevacizumab on growth and bone development in pediatric and adolescent patients with solid tumors. Procedure Clinical data were pooled from five phase I/II trials of bevacizumab versus chemotherapy: BERNIE, HERBY, and AVF4117s enrolled newly diagnosed patients, AVF3842s and AVF2771s enrolled patients with relapsed/refractory disease. Height, weight, body mass index (BMI), and bone‐age data were pooled by treatment group. Growth charts were used to track and monitor growth in relation to a reference population of healthy children. Bone age was measured based on X‐ray of the left hand and wrist. Analyses were exploratory/descriptive. Results Overall, 268 patients received bevacizumab ± chemotherapy and 135 received chemotherapy alone. Baseline characteristics were generally balanced. Median duration of long‐term follow‐up was 41.8 months (range, 2.4‐75.1) with bevacizumab and 22.9 months (range, 2.8‐69.2) with chemotherapy alone. Patients had age‐appropriate baseline height and weight. Mean height and weight percentiles decreased over time in both treatment groups, but remained within the normal range (height: mean standard deviation score [SDS] range −2 to +3; weight: mean SDS range −2 to +1). Similar trends were seen in BMI. A tendency for reduced growth velocity relative to the reference population was observed at 6 months and 1 year in both groups, but there was no additional decrease for patients receiving bevacizumab. Conclusion Bevacizumab did not appear to have additional negative effects on growth or development of pediatric and adolescent patients with solid tumors.