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Bevacizumab + prednisone is a sequential combination regimen currently under investigation for the treatment of radiation-induced brain injury (radiation necrosis). The regimen consists of bevacizumab, a recombinant humanized monoclonal antibody that targets and neutralizes vascular endothelial growth factor A (VEGF-A), followed by prednisone, a synthetic corticosteroid. By inhibiting VEGF-A, bevacizumab reduces pathological vascular permeability and associated brain edema, which are hallmarks of radiation-induced tissue damage. Prednisone acts as a glucocorticoid receptor agonist, providing additional anti-inflammatory effects. This combination is being evaluated in Phase 2 clinical trials, specifically in patients with nasopharyngeal carcinoma who have developed brain injury following radiotherapy, to determine if the sequential addition of a steroid improves clinical outcomes compared to bevacizumab monotherapy.
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