Long-term survival in patients with recurrent glioblastoma treated with bevacizumab: a multicentric retrospective study

Purpose Recurrence of glioblastoma (GB) occurs in most patients after standard concomitant temozolomide-based radiochemotherapy (CTRC). Bevacizumab (BV), an anti-VEGF antibody, has an effect on progression-free survival (PFS) but not on overall survival (OS). However, a small part of the patients ex...

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Bibliographic Details
Published in:Journal of neuro-oncology 2019-09, Vol.144 (2), p.419-426
Main Authors: Morisse, M. C., Etienne-Selloum, N., Bello-Roufai, D., Blonski, M., Taillandier, L., Lorgis, V., Noël, G., Ahle, G., Durán-Peña, A., Boone, M., Chauffert, B.
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Angiogenesis Inhibitors - therapeutic use
Automatic
Bevacizumab
Bevacizumab - therapeutic use
Brain cancer
Brain Neoplasms - drug therapy
Brain Neoplasms - mortality
Brain Neoplasms - pathology
Cancer
Chemoradiotherapy
Clinical Study
Corticosteroids
Engineering Sciences
Female
Follow-Up Studies
Glioblastoma
Glioblastoma - drug therapy
Glioblastoma - mortality
Glioblastoma - pathology
Humans
Immunotherapy
Life Sciences
Male
Medical records
Medicine
Medicine & Public Health
Middle Aged
Monoclonal antibodies
Multivariate analysis
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - mortality
Neoplasm Recurrence, Local - pathology
Neurology
Oncology
Prognosis
Retrospective Studies
Survival
Survival Rate
Survivors - statistics & numerical data
Targeted cancer therapy
Temozolomide
Vascular endothelial growth factor
Young Adult
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Summary:Purpose Recurrence of glioblastoma (GB) occurs in most patients after standard concomitant temozolomide-based radiochemotherapy (CTRC). Bevacizumab (BV), an anti-VEGF antibody, has an effect on progression-free survival (PFS) but not on overall survival (OS). However, a small part of the patients experience a survival, longer than expected. This retrospective study aims to characterize long responder (LR) patients treated with BV for a first or second GBM recurrence. Methods Medical records from patients (814) who received BV for a first or second recurrence of primary glioblastoma between September 2010 and September 2015, and initially treated by CTRC were analyzed. Patients, who had at least a stable disease according to RANO criteria at 12 months from the start of BV, were included. Patients who had, a secondary GB, or received BV in neoadjuvant or adjuvant setting were excluded. Results We focused on 65 LR patients without progression 12 months after the first injection of BV (8%). Median PFS was 21.7 months [95% CI (19.3; 27.2)] and median OS was 31.1 months [95% CI (24.3; 37.5)] from the start of BV. No prognostic factor was associated with OS in multivariate analysis. Karnofsky performance status, neurological status and corticosteroid dose were stable at 12 months. Conclusions Our results highlight that among patients receiving bevacizumab in first or second recurrence, one patient out of twelve could be classified as LR. A median OS of 31.1 months from the start of BV could be expected in this subpopulation. These findings reinforce the potential benefit of the use of BV in the situation of recurrence. 256 words
ISSN:0167-594X
1573-7373
DOI:10.1007/s11060-019-03245-5