{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T05:16:23Z","timestamp":1792905383495,"version":"4.5.0"},"reference-count":50,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T00:00:00Z","timestamp":1665705600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Bevacizumab is increasingly used in children with pediatric low-grade glioma (PLGG) despite limited evidence. A nationwide UK service evaluation was conducted to provide larger cohort \u201creal life\u201d safety and efficacy data including functional visual outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Children receiving bevacizumab-based treatments (BBT) for PLGG (2009\u20132020) from 11 centers were included. Standardized neuro-radiological (RANO-LGG) and visual (logMAR visual acuity) criteria were used to assess clinical\u2013radiological correlation, survival outcomes and multivariate prognostic analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Eighty-eight children with PLGG received BBT either as 3rd line with irinotecan (85%) or alongside 1st\/2nd line chemotherapies (15%). Toxicity was limited and minimal. Partial response (PR, 40%), stable disease (SD, 49%), and progressive disease (PD, 11%) were seen during BBT. However, 65% progressed at 8 months (median) from BBT cessation, leading to a radiology-based 3 yr-progression-free survival (PFS) of 29%. Diencephalic syndrome (P = .03) was associated with adverse PFS. Pre-existing visual morbidity included unilateral (25%) or bilateral (11%) blindness. Improvement (29%) or stabilization (49%) of visual acuity was achieved, more often in patients\u2019 best eyes. Vision deteriorated during BBT in 14 (22%), with 3-year visual-PFS of 53%; more often in patients\u2019 worst eyes. A superior visual outcome (P = .023) was seen in neurofibromatosis type 1-associated optic pathway glioma (OPG). Concordance between visual and radiological responses was 36%; optimized to 48% using only best eye responses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BBTs provide effective short-term PLGG control and delay further progression, with a better sustained visual (best &amp;gt; worst eye) than radiological response. Further research could optimize the role of BBT toward a potentially sight-saving strategy in OPG.<\/jats:p><\/jats:sec>","DOI":"10.1093\/neuonc\/noac223","type":"journal-article","created":{"date-parts":[[2022,10,14]],"date-time":"2022-10-14T10:56:35Z","timestamp":1665744995000},"page":"774-785","source":"Crossref","is-referenced-by-count":50,"title":["A nationwide evaluation of bevacizumab-based treatments in pediatric low-grade glioma in the UK: Safety, efficacy, visual morbidity, and outcomes"],"prefix":"10.1093","volume":"25","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5911-0541","authenticated-orcid":false,"given":"Katherine","family":"Green","sequence":"first","affiliation":[{"name":"Great Ormond Street Hospital London , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paraskevi","family":"Panagopoulou","sequence":"additional","affiliation":[{"name":"Great Ormond Street Hospital London , 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