Bevacizumab versus alkylating chemotherapy in recurrent glioblastoma

Background The use of alkylating chemotherapy versus bevacizumab for recurrent glioblastoma remains controversial. Here, we tested the hypothesis that the activity of alkylators, but not that of bevacizumab, would be associated with the O 6 - methylguanine DNA methyltransferase ( MGMT ) promoter met...

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Bibliographic Details
Published in:Journal of cancer research and clinical oncology 2020-03, Vol.146 (3), p.659-670
Main Authors: Seystahl, Katharina, Hentschel, Bettina, Loew, Sarah, Gramatzki, Dorothee, Felsberg, Jörg, Herrlinger, Ulrich, Westphal, Manfred, Schackert, Gabriele, Thon, Niklas, Tatagiba, Marcos, Pietsch, Torsten, Reifenberger, Guido, Löffler, Markus, Wick, Wolfgang, Weller, Michael
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Alkylating agents
Antineoplastic Agents, Alkylating - therapeutic use
Antineoplastic Agents, Immunological - therapeutic use
Bevacizumab
Bevacizumab - therapeutic use
Brain cancer
Brain Neoplasms - drug therapy
Brain Neoplasms - genetics
Cancer Research
Chemotherapy
Deoxyribonucleic acid
DNA
DNA methylation
DNA Methylation - genetics
DNA methyltransferase
DNA Modification Methylases - genetics
DNA Repair Enzymes - genetics
Female
Glioblastoma
Glioblastoma - drug therapy
Glioblastoma - genetics
Glioma
Hematology
Humans
Immunotherapy
Internal Medicine
Irinotecan
Male
Medicine
Medicine & Public Health
Methylguanine
Middle Aged
Monoclonal antibodies
Neoplasm Recurrence, Local - drug therapy
Neoplasm Recurrence, Local - genetics
O6-methylguanine-DNA methyltransferase
Oncology
Original Article – Clinical Oncology
Progression-Free Survival
Promoter Regions, Genetic - genetics
Retrospective Studies
Targeted cancer therapy
Tumor Suppressor Proteins - genetics
Young Adult
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Summary:Background The use of alkylating chemotherapy versus bevacizumab for recurrent glioblastoma remains controversial. Here, we tested the hypothesis that the activity of alkylators, but not that of bevacizumab, would be associated with the O 6 - methylguanine DNA methyltransferase ( MGMT ) promoter methylation status. Methods We analyzed a cohort of patients treated at centers of the German Glioma Network or the University Hospital Zurich with alkylating agent-based chemotherapy ( n  = 260) or bevacizumab without or with irinotecan ( n  = 84) for first recurrence of glioblastoma. Outcome was stratified for O 6 - methylguanine DNA methyltransferase ( MGMT ) status and crossover to bevacizumab or alkylators at further progression. Results Median post-recurrence survival-1 (PRS-1) for patients receiving alkylating agents at first recurrence was longer than with bevacizumab (11.1 versus 7.4 months, p  
ISSN:0171-5216
1432-1335
DOI:10.1007/s00432-019-03086-9