Bevacizumab continuation beyond initial bevacizumab progression among recurrent glioblastoma patients

• Published in: British journal of cancer 2012-10, Vol.107 (9), p.1481-1487
• Main Authors: Reardon, D A, Herndon, J E, Peters, K B, Desjardins, A, Coan, A, Lou, E, Sumrall, A L, Turner, S, Lipp, E S, Sathornsumetee, S, Rich, J N, Sampson, J H, Friedman, A H, Boulton, S T, Bigner, D D, Friedman, H S, Vredenburgh, J J
• Format: Article
• Language: English
• Subjects: 692/308/2779/109/1941; 692/699/67/1059; 692/699/67/1922; Adult; Aged; Angiogenesis Inhibitors - administration & dosage; Angiogenesis Inhibitors - adverse effects; Antibodies, Monoclonal, Humanized - administration & dosage; Antibodies, Monoclonal, Humanized - adverse effects; Bevacizumab; Biological and medical sciences; Biomedical and Life Sciences; Biomedicine; Brain cancer; Brain Neoplasms - drug therapy; Brain research; Cancer Research; Cancer therapies; Clinical Study; Clinical trials; Disease Progression; Drug Administration Schedule; Drug Resistance; Epidemiology; FDA approval; Glioblastoma - drug therapy; Humans; Medical research; Medical sciences; Medicine; Middle Aged; Molecular Medicine; Neoplasm Recurrence, Local - drug therapy; Neurology; Oncology; Retrospective Studies; Survival Analysis; Treatment Outcome; Tumors; Tumors of the nervous system. Phacomatoses; Young Adult
• ISSN: 0007-0920; 1532-1827
• DOI: 10.1038/bjc.2012.415

Background: Bevacizumab improves outcome for most recurrent glioblastoma patients, but the duration of benefit is limited and survival after initial bevacizumab progression is poor. We evaluated bevacizumab continuation beyond initial progression among recurrent glioblastoma patients as it is a common, yet unsupported practice in some countries. Methods: We analysed outcome among all patients ( n =99) who received subsequent therapy after progression on one of five consecutive, single-arm, phase II clinical trials evaluating bevacizumab regimens for recurrent glioblastoma. Of note, the five trials contained similar eligibility, treatment and assessment criteria, and achieved comparable outcome. Results: The median overall survival (OS) and OS at 6 months for patients who continued bevacizumab therapy ( n =55) were 5.9 months (95% confidence interval (CI): 4.4, 7.6) and 49.2% (95% CI: 35.2, 61.8), compared with 4.0 months (95% CI: 2.1, 5.4) and 29.5% (95% CI: 17.0, 43.2) for patients treated with a non-bevacizumab regimen ( n =44; P =0.014). Bevacizumab continuation was an independent predictor of improved OS (hazard ratio=0.64; P =0.04). Conclusion: The results of our retrospective pooled analysis suggest that bevacizumab continuation beyond initial progression modestly improves survival compared with available non-bevacizumab therapy for recurrent glioblastoma patients require evaluation in an appropriately randomised, prospective trial.