Congress of Neurological Surgeons systematic review and evidence-based guidelines update on the role of targeted therapies and immunotherapies in the management of progressive glioblastoma.

Adult Antineoplastic Agents / therapeutic use Bevacizumab / therapeutic use Brain Neoplasms Glioblastoma / drug therapy Humans Immunotherapy Neurosurgeons Practice Guidelines as Topic
Guidelines update Immunotherapy Progressive glioblastoma Targeted therapy

Journal

Journal of neuro-oncology
ISSN: 1573-7373
Titre abrégé: J Neurooncol
Pays: United States
ID NLM: 8309335

Informations de publication

Date de publication:
Jun 2022
Historique:
received: 08 09 2021
accepted: 11 10 2021
pubmed: 26 10 2021
medline: 22 6 2022
entrez: 25 10 2021
Statut: ppublish

Résumé

The following questions and recommendations are pertinent to the following: TARGET POPULATION: These recommendations apply to adults with progressive GBM who have undergone standard primary treatment with surgery and/or chemoradiation. QUESTION 1: In adults with progressive glioblastoma is the use of bevacizumab as monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? Level III: Treatment with bevacizumab is suggested in the treatment of progressive GBM, as it provides improved disease control compared to historical controls as measured by best imaging response and progression free survival at 6 months, while not providing evidence for improvement in overall survival. QUESTION 2: In adults with progressive glioblastoma is the use of bevacizumab as combination therapy with cytotoxic agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? Level III: There is insufficient evidence to show benefit or harm of bevacizumab in combination with cytotoxic therapies in progressive glioblastoma due to a lack of evidence supporting a clearly defined benefit without significant toxicity. QUESTION 3: In adults with progressive glioblastoma is the use of bevacizumab as a combination therapy with targeted agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question. QUESTION 4: In adults with progressive glioblastoma is the use of targeted agents as monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question. QUESTION 5: In adults with progressive glioblastoma is the use of targeted agents in combination with cytotoxic therapies superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question. QUESTION 6: In adults with progressive glioblastoma is the use of immunotherapy monotherapy superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question. QUESTION 7: In adults with progressive glioblastoma is the use of immunotherapy in combination with targeted agents superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question. QUESTION 8: In adults with progressive glioblastoma is the use of immunotherapy in combination with bevacizumab superior to standard salvage cytotoxic chemotherapy as measured by progression free survival and overall survival? There is insufficient evidence to support a recommendation regarding this question.

Identifiants

DOI: 10.1007/s11060-021-03876-7 PMID: 34694567 PMC: PMC8543777
pubmed: 34694567
doi: 10.1007/s11060-021-03876-7
pii: 10.1007/s11060-021-03876-7
pmc: PMC8543777
doi:

Substances chimiques

Antineoplastic Agents 0
Bevacizumab 2S9ZZM9Q9V

Types de publication

Journal Article Systematic Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

265-321

Informations de copyright

© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

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Auteurs

Evan Winograd (E)

Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA.

Isabelle Germano (I)

Department of Neurosurgery, The Mount Sinai Hospital, New York, NY, USA.

Patrick Wen (P)

Center for Neuro-Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.

Jeffrey J Olson (JJ)

Department of Neurosurgery, Emory University School of Medicine, Atlanta, GA, USA.

D Ryan Ormond (DR)

Department of Neurosurgery, University of Colorado School of Medicine, Aurora, CO, USA. David.ormond@cuanschutz.edu.
Department of Neurosurgery, University of Colorado Anschutz Medical Campus, 12631 E. 17th Ave., Mail Stop C307, Aurora, CO, 80045, USA. David.ormond@cuanschutz.edu.
ORCID: 0000-0001-7027-2915

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