Bevacizumab versus alkylating chemotherapy in recurrent glioblastoma.
Adult
Aged
Aged, 80 and over
Antineoplastic Agents, Alkylating
/ therapeutic use
Antineoplastic Agents, Immunological
/ therapeutic use
Bevacizumab
/ therapeutic use
Brain Neoplasms
/ drug therapy
DNA Methylation
/ genetics
DNA Modification Methylases
/ genetics
DNA Repair Enzymes
/ genetics
Female
Glioblastoma
/ drug therapy
Humans
Male
Middle Aged
Neoplasm Recurrence, Local
/ drug therapy
Progression-Free Survival
Promoter Regions, Genetic
/ genetics
Retrospective Studies
Tumor Suppressor Proteins
/ genetics
Young Adult
Bevacizumab
Chemotherapy
Glioblastoma
Nitrosourea
Temozolomide
Journal
Journal of cancer research and clinical oncology
ISSN: 1432-1335
Titre abrégé: J Cancer Res Clin Oncol
Pays: Germany
ID NLM: 7902060
Informations de publication
Date de publication:
Mar 2020
Mar 2020
Historique:
received:
16
08
2019
accepted:
15
11
2019
pubmed:
23
11
2019
medline:
29
2
2020
entrez:
23
11
2019
Statut:
ppublish
Résumé
The use of alkylating chemotherapy versus bevacizumab for recurrent glioblastoma remains controversial. Here, we tested the hypothesis that the activity of alkylators, but not that of bevacizumab, would be associated with the O We analyzed a cohort of patients treated at centers of the German Glioma Network or the University Hospital Zurich with alkylating agent-based chemotherapy (n = 260) or bevacizumab without or with irinotecan (n = 84) for first recurrence of glioblastoma. Outcome was stratified for O Median post-recurrence survival-1 (PRS-1) for patients receiving alkylating agents at first recurrence was longer than with bevacizumab (11.1 versus 7.4 months, p < 0.001). The use of alkylators was associated with longer PRS-1 for patients with a methylated versus unmethylated MGMT promoter (p = 0.017). For patients receiving bevacizumab, PRS-1 was not different with or without MGMT promoter methylation. PRS-1 was longer in patients receiving alkylating chemotherapy compared to bevacizumab for patients with methylated (p < 0.001) or unmethylated MGMT promoter (p = 0.034). For patients with alkylators at first recurrence receiving bevacizumab at any further recurrence, PRS-1 was longer than in patients receiving bevacizumab first and alkylators thereafter (p = 0.002). This study confirms limited value of bevacizumab in recurrent glioblastoma independent of MGMT status. Alkylating agents have activity in recurrent glioblastoma, especially in the context of MGMT promoter methylation.
Sections du résumé
BACKGROUND
BACKGROUND
The use of alkylating chemotherapy versus bevacizumab for recurrent glioblastoma remains controversial. Here, we tested the hypothesis that the activity of alkylators, but not that of bevacizumab, would be associated with the O
METHODS
METHODS
We analyzed a cohort of patients treated at centers of the German Glioma Network or the University Hospital Zurich with alkylating agent-based chemotherapy (n = 260) or bevacizumab without or with irinotecan (n = 84) for first recurrence of glioblastoma. Outcome was stratified for O
RESULTS
RESULTS
Median post-recurrence survival-1 (PRS-1) for patients receiving alkylating agents at first recurrence was longer than with bevacizumab (11.1 versus 7.4 months, p < 0.001). The use of alkylators was associated with longer PRS-1 for patients with a methylated versus unmethylated MGMT promoter (p = 0.017). For patients receiving bevacizumab, PRS-1 was not different with or without MGMT promoter methylation. PRS-1 was longer in patients receiving alkylating chemotherapy compared to bevacizumab for patients with methylated (p < 0.001) or unmethylated MGMT promoter (p = 0.034). For patients with alkylators at first recurrence receiving bevacizumab at any further recurrence, PRS-1 was longer than in patients receiving bevacizumab first and alkylators thereafter (p = 0.002).
CONCLUSIONS
CONCLUSIONS
This study confirms limited value of bevacizumab in recurrent glioblastoma independent of MGMT status. Alkylating agents have activity in recurrent glioblastoma, especially in the context of MGMT promoter methylation.
Identifiants
pubmed: 31754832
doi: 10.1007/s00432-019-03086-9
pii: 10.1007/s00432-019-03086-9
doi:
Substances chimiques
Antineoplastic Agents, Alkylating
0
Antineoplastic Agents, Immunological
0
Tumor Suppressor Proteins
0
Bevacizumab
2S9ZZM9Q9V
DNA Modification Methylases
EC 2.1.1.-
MGMT protein, human
EC 2.1.1.63
DNA Repair Enzymes
EC 6.5.1.-
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
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