Is bevacizumab good enough for avoiding to stop immunotherapy due to corticosteroid need in symptomatic brain edema due to radionecrosis, during immunotherapy for lung Cancer?
For tumoral acute brain edema nothing is more efficacious than corticosteroids. Monoclonal antibodies like Bevacizumab can only prevent recurrence of glial tumors for a limited time without direct effect on brain edema. Immunotherapy has no direct effect on edema either.
We frequently use Bevacizumab as a steroid-sparing agent in patients with radiation necrosis. So I think yes you can use it. There is also evidence to suggest additive action of immune checkpoint and bevacizumab in adenocarcinoma of the lung.
This is an interesting question. I don't think that anything is more efficacious than corticosteroids in minimizing/reversing cerebral edema. I admittedly do not have experience in using bevacizumab in the setting of necrosis, but wouldn't there be a concern for increased bleeding risk?
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