Bevacizumab in recurrent high-grade glioma: a single institution retrospective analysis on 92 patients.
Adult
Aged
Antineoplastic Agents, Immunological
/ adverse effects
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Bevacizumab
/ adverse effects
Brain Neoplasms
/ drug therapy
Female
Glioblastoma
/ drug therapy
Glioma
/ drug therapy
Humans
Male
Middle Aged
Neoplasm Grading
Neoplasm Recurrence, Local
/ drug therapy
Retrospective Studies
Survival Analysis
Bevacizumab
Central nervous system
Glioblastoma
High-grade glioma
Journal
La Radiologia medica
ISSN: 1826-6983
Titre abrégé: Radiol Med
Pays: Italy
ID NLM: 0177625
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
18
08
2020
accepted:
20
05
2021
pubmed:
4
6
2021
medline:
27
8
2021
entrez:
3
6
2021
Statut:
ppublish
Résumé
High-grade gliomas are among the most aggressive central nervous system primary tumors, with a high risk of recurrence and a poor prognosis. Re-operation, re-irradiation, chemotherapy are options in this setting. No-best therapy has been established. Bevacizumab was approved on the basis of two Phase 2 trials that evaluated its efficacy in patients with recurrent glioblastoma. We have retrospectively review data of patients with high-grade glioma treated at our institution that undergone radiological or histological progression after at least one systemic treatment for recurrent disease. Bevacizumab was administered alone or in combination with chemotherapy until disease progression or unacceptable toxicity. Bevacizumab regimen was analyzed to assess PFS and OS. Histological, molecular and clinical features of the entire cohort were collected. We reviewed data from 92 patients, treated from April 2009 to November 2019, with histologically confirmed diagnosis of high-grade gliomas and recurrent disease. A PFS of 55.2%, 22.9% and 9.6% was observed at 6, 12 and 24 months, respectively. Performance status, age at diagnosis (< 65 or > 65 ys.) and use of corticosteroids during bevacizumab therapy were strongly associated with PFS. The OS was 74.9% at 6 months, 31.7% at 12 months, 10.1% at 24 months. In our cohort, 51.1% were long-term responders (PFS > 6 months). Globally, bevacizumab treatment was well tolerated. Our analysis confirms the efficacy of bevacizumab in recurrent high-grade glioma patients with an acceptable toxicity profile, in keeping with its known safety in the literature.
Sections du résumé
BACKGROUND
BACKGROUND
High-grade gliomas are among the most aggressive central nervous system primary tumors, with a high risk of recurrence and a poor prognosis. Re-operation, re-irradiation, chemotherapy are options in this setting. No-best therapy has been established. Bevacizumab was approved on the basis of two Phase 2 trials that evaluated its efficacy in patients with recurrent glioblastoma.
MATERIALS AND METHODS
METHODS
We have retrospectively review data of patients with high-grade glioma treated at our institution that undergone radiological or histological progression after at least one systemic treatment for recurrent disease. Bevacizumab was administered alone or in combination with chemotherapy until disease progression or unacceptable toxicity. Bevacizumab regimen was analyzed to assess PFS and OS. Histological, molecular and clinical features of the entire cohort were collected.
RESULTS
RESULTS
We reviewed data from 92 patients, treated from April 2009 to November 2019, with histologically confirmed diagnosis of high-grade gliomas and recurrent disease. A PFS of 55.2%, 22.9% and 9.6% was observed at 6, 12 and 24 months, respectively. Performance status, age at diagnosis (< 65 or > 65 ys.) and use of corticosteroids during bevacizumab therapy were strongly associated with PFS. The OS was 74.9% at 6 months, 31.7% at 12 months, 10.1% at 24 months. In our cohort, 51.1% were long-term responders (PFS > 6 months). Globally, bevacizumab treatment was well tolerated.
CONCLUSION
CONCLUSIONS
Our analysis confirms the efficacy of bevacizumab in recurrent high-grade glioma patients with an acceptable toxicity profile, in keeping with its known safety in the literature.
Identifiants
pubmed: 34081269
doi: 10.1007/s11547-021-01381-5
pii: 10.1007/s11547-021-01381-5
pmc: PMC8370943
doi:
Substances chimiques
Antineoplastic Agents, Immunological
0
Bevacizumab
2S9ZZM9Q9V
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1249-1254Informations de copyright
© 2021. The Author(s).
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