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J Clin Neurosci. 2017 Oct;44:101-106. doi: 10.1016/j.jocn.2017.06.070. Epub 2017 Jul 12.

Clinical outcomes in recurrent glioblastoma with bevacizumab therapy: An analysis of the literature.

Author information

1
Department of Medicine University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, United States.
2
Department of Biostatistics and Medical Informatics, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, United States; University of Wisconsin Carbone Cancer Center, UWSMPH, United States.
3
University of Wisconsin Carbone Cancer Center, UWSMPH, United States; Departments of Medicine, Human Oncology and Neurology, K4/534 Clinical Science Center, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, United States. Electronic address: hirobins@wisc.edu.

Abstract

Bevacizumab (BEV) is a common treatment for recurrent glioblastoma (GBM). After progression on BEV, there is no consensus on subsequent therapy, as multiple chemotherapy trials have failed to demonstrate discernible activity for salvage. A previous review (995 patients) estimated a progression free survival (PFS) on BEV of 4.2months (SD±2.1) with an overall survival (OS) after progression on BEV at 3.8months (SD±1). We endeavored to establish a more rigorous historical control, both as a benchmark for efficacy, and a prognostic tool for clinical practice. A comprehensive literature review was performed utilizing PubMed and societal presentation abstracts. A total 2388 patients from 53 arms of 42 studies were analyzed in three groups: 1) thirty-two studies in which survival post-BEV was determined by subtracting PFS from OS (2045 patients): PFS on BEV=4.38months (95% CI 4.09-4.68); OS post-BEV=3.36months (95% CI 3.12-3.66); 2) two studies (94 patients) in which OS post-BEV is reported: OS=3.26 (95% CI 2.39-4.42); 3) eight studies of salvage therapy after progression on BEV (249 patients): of OS post-BEV=4.46months (95% CI 3.68-5.54). These estimates provide a firm historical control for PFS on BEV, as well as OS after disease progression on BEV therapy.

KEYWORDS:

Bevacizumab; Overall survival; Recurrent glioblastoma

PMID:
28711289
PMCID:
PMC5581989
DOI:
10.1016/j.jocn.2017.06.070
[Indexed for MEDLINE]
Free PMC Article

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