Prognostic factors in recurrent glioblastoma patients treated with bevacizumab

• Published in: Journal of neuro-oncology 2016-08, Vol.129 (1), p.93-100
• Main Authors: Schaub, Christina, Tichy, Julia, Schäfer, Niklas, Franz, Kea, Mack, Frederic, Mittelbronn, Michel, Kebir, Sied, Thiepold, Anna-Luisa, Waha, Andreas, Filmann, Natalie, Banat, Mohammed, Fimmers, Rolf, Steinbach, Joachim P., Herrlinger, Ulrich, Rieger, Johannes, Glas, Martin, Bähr, Oliver
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Antineoplastic Agents, Immunological - therapeutic use; Antineoplastic Agents, Phytogenic - therapeutic use; Bevacizumab - therapeutic use; Brain Neoplasms - diagnosis; Brain Neoplasms - drug therapy; Brain Neoplasms - epidemiology; Camptothecin - analogs & derivatives; Camptothecin - therapeutic use; Clinical Study; Disease-Free Survival; Drug Therapy, Combination; Female; Glioblastoma - diagnosis; Glioblastoma - drug therapy; Glioblastoma - epidemiology; Humans; Karnofsky Performance Status; Male; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - diagnosis; Neoplasm Recurrence, Local - drug therapy; Neoplasm Recurrence, Local - epidemiology; Neurology; Oncology; Prognosis; Retrospective Studies; Treatment Outcome; Young Adult
• ISSN: 0167-594X; 1573-7373
• DOI: 10.1007/s11060-016-2144-7

The value of bevacizumab (BEV) in recurrent glioblastoma is unclear. Imaging parameters and progression-free survival (PFS) are problematic endpoints. Few data exist on clinical factors influencing overall survival (OS) in unselected patients with recurrent glioblastoma exposed to BEV. We retrospectively analyzed 174 patients with recurrent glioblastoma treated with BEV at two German brain tumor centers. We evaluated general patient characteristics, MGMT status, pretreatment, concomitant oncologic treatment and overall survival. Karnofsky performance score, number of prior chemotherapies, number of prior recurrences and combined treatment with irinotecan (IRI) were significantly associated with OS in univariate analysis. We did not find differences in OS related to sex, age, histology, MGMT status, prior surgical treatment or number of prior radiotherapies. Combined treatment with IRI and higher KPS both remained significantly associated with prolonged survival in multivariate analysis, but patients receiving IRI co-treatment had less advanced disease. Grouping into clinically relevant categories revealed an OS of 16.9 months from start of BEV in patients with first recurrence and KPS ≥ 80 % (n = 25). In contrast, in patients with second recurrence and KPS