Bevacizumab continuation beyond initial bevacizumab progression among recurrent glioblastoma patients

D. A. Reardon, J. E. Herndon, K. B. Peters, A. Desjardins, A. Coan, E. Lou, A. L. Sumrall, S. Turner, E. S. Lipp, S. Sathornsumetee, J. N. Rich, J. H. Sampson, A. H. Friedman, S. T. Boulton, D. D. Bigner, H. S. Friedman, J. J. Vredenburgh

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61 Scopus citations

Abstract

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 (n99) 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 (n55) 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 (n44; P0.014). Bevacizumab continuation was an independent predictor of improved OS (hazard ratio0.64; P0.04). 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.

Original languageEnglish (US)
Pages (from-to)1481-1487
Number of pages7
JournalBritish Journal of Cancer
Volume107
Issue number9
DOIs
StatePublished - Oct 23 2012

Keywords

  • angiogenesis
  • bevacizumab
  • glioblastoma
  • malignant glioma
  • vascular endothelial growth factor

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