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24.01.2019 | Clinical Study

EGFR amplification and classical subtype are associated with a poor response to bevacizumab in recurrent glioblastoma

verfasst von: Koos E. Hovinga, Heather J. McCrea, Cameron Brennan, Jason Huse, Junting Zheng, Yoshua Esquenazi, Katherine S. Panageas, Viviane Tabar

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2019

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Abstract

Purpose

The highly vascular malignant brain tumor glioblastoma (GBM) appears to be an ideal target for anti-angiogenic therapy; however, clinical trials to date suggest the VEGF antibody bevacizumab affects only progression-free survival. Here we analyze a group of patients with GBM who received bevacizumab treatment at recurrence and are stratified according to tumor molecular and genomic profile (TCGA classification), with the goal of identifying molecular predictors of the response to bevacizumab.

Methods

We performed a retrospective review of patients with a diagnosis of glioblastoma who were treated with bevacizumab in the recurrent setting at our hospital, from 2006 to 2014. Treatment was discontinued by the treating neuro-oncologists, based on clinical and radiographic criteria. Pre- and post-treatment imaging and genomic subtype were available on 80 patients. We analyzed time on bevacizumab and time to progression. EGFR gene amplification was determined by FISH.

Results

Patients with classical tumors had a significantly shorter time on bevacizumab than mesenchymal, and proneural patients (2.7 vs. 5.1 vs. 6.4 and 6.0 months respectively, p = 0.011). Classical subtype and EGFR gene amplification were significantly associated with a shorter time to progression both in univariate (p < 0.001 and p = 0.007, respectively) and multivariate analysis (both p = 0.010).

Conclusion

EGFR gene amplification and classical subtype by TCGA analysis are associated with significantly shorter time to progression for patients with recurrent GBM when treated with bevacizumab. These findings can have a significant impact on decision-making and should be further validated prospectively.

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Titel: EGFR amplification and classical subtype are associated with a poor response to bevacizumab in recurrent glioblastoma
verfasst von: Koos E. Hovinga
Heather J. McCrea
Cameron Brennan
Jason Huse
Junting Zheng
Yoshua Esquenazi
Katherine S. Panageas
Viviane Tabar
Publikationsdatum: 24.01.2019
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2019
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-019-03102-5

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