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J Neurooncol. 2017 Jul;133(3):455-467. doi: 10.1007/s11060-017-2477-x. Epub 2017 May 19.

The role of bevacizumab in the treatment of glioblastoma.

Author information

1
Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, 3801 Rue University, Montreal, H3A 2B4, QC, Canada. roberto.diaz@mcgill.ca.
2
College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, FL, USA.
3
Department of Biological Sciences, Florida International University, Miami, FL, USA.
4
Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.
5
Department of Neurological Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.

Abstract

Bevacizumab has been used in patients with GBM as a salvage therapy since its approval in the United States for recurrent GBM in 2009. In order to review the therapeutic effect of bevacizumab in the primary and recurrent clinical setting we have performed a systematic analysis of data from the published literature. Weighted median progression free survival and overall survival were calculated and compared to standard therapy or other experimental therapies. A qualitative analysis of the limited studies on health related quality of life and effects on steroid requirements was also undertaken. We found that the available literature supports the use of bevacizumab for prolonging PFS and OS in the recurrent setting either alone or in combination with a cytotoxic agent (Pā€‰<ā€‰0.05), but does not support its use in the primary setting (Pā€‰>ā€‰0.05). The survival advantage of bevacizumab compared to experimental therapy at recurrence is limited to 4 months. There is no additional benefit reported to date in health-related quality of life with the use of bevacizumab, although it may reduce steroid requirements. On average there is one side-effect event per patient and 74% of these events are grade 3 toxicity or higher. Further studies investigating the role of bevacizumab in combination with cytotoxic agents at recurrence are awaited.

KEYWORDS:

Avastin; Bevacizumab; Chemotherapy; Glioblastoma; Survival; VEGF

PMID:
28527008
DOI:
10.1007/s11060-017-2477-x
[Indexed for MEDLINE]

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