Jazz flute.

It’s Valentines week so put on some Herbie Mann while you read the phase 2 HERBY trial published in JCO last week. It randomized pediatric patients with high grade glioma to radiation and temozolomide +/- bevacizumab. The short version is that bevacizumab improved no outcomes and had worse toxicity. But let’s dig a little deeper. Bev improves progression free survival in adult patients, right? Maybe, maybe not. Some people are starting to wonder if it just produces a “pseudoresponse” by reducing tumor enhancement. That’s where HERBY gets interesting...at least to us. Pediatric gliomas are less likely to enhance--only 20% did in this trial--so perhaps they just had less potential for a pseudoresponse. TBL: In a population of pediatric high grade gliomas, bevacizumab did not reduce the rate of tumor progression.