Skip to main content
Erschienen in: Medical Oncology 2/2015

01.02.2015 | Original Paper

Single-agent bevacizumab is an effective treatment in recurrent glioblastoma

verfasst von: Ilhan Hacibekiroglu, Hilmi Kodaz, Bulent Erdogan, Esma Turkmen, Melike Ozcelik, Asim Esenkaya, Haci Mehmet Saygi, Sernaz Uzunoglu, Irfan Cicin

Erschienen in: Medical Oncology | Ausgabe 2/2015

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study was to evaluate the efficiency and safety of single-agent bevacizumab therapy for recurrent glioblastoma multiforme (GBM). We identified patients with histologically confirmed glioblastoma and World Health Organization Grade III glioma who were previously treated with temozolomide plus radiotherapy and received 10 mg/kg bevacizumab intravenous infusion every 2 weeks until disease progression for recurrent disease. A total 24 patients included to this study. Twenty-two patients had GBM, and two patients had WHO grade III glioma. No complete response was observed, five patients (20.8 %) had partial response, nine patients (37.5 %) had stable diseases, and ten patients (41.7 %) had progressive diseases. The overall response rate was 20.8 %. The 6-month PFS rate (PFS6) and median PFS were determined as 37.5 % and 4.1 months, respectively. Median OS was 6.4 months. Performance status of 17 (70.8 %) patients was improved following bevacizumab regimen. Univariate analysis showed that improvement in performance status (IPS) following bevacizumab therapy was a significant predictor of both PFS (p < 0.001) and OS (p < 0.020). Bevacizumab-related adverse effects were observed in 13 (54.1 %) patients. Grade 3–4 toxicity was observed in 4 (16.6 %) patients. Therapy interruptions were experienced in two patients due to adverse effects. Single-agent bevacizumab is an effective and safe treatment alternative in recurrent GBM. IPS following bevacizumab therapy was a significant predictor of both PFS and OS.
Literatur
1.
Zurück zum Zitat Grossman SA, Ye X, Piantadosi S, Desideri S, Nabors LB, Rosenfeld M, et al. Survival of patients with newly diagnosed glioblastoma treated with radiation and temozolomide in research studies in the United States. Clin Cancer Res. 2010;16(8):2443–9.CrossRefPubMedCentralPubMed Grossman SA, Ye X, Piantadosi S, Desideri S, Nabors LB, Rosenfeld M, et al. Survival of patients with newly diagnosed glioblastoma treated with radiation and temozolomide in research studies in the United States. Clin Cancer Res. 2010;16(8):2443–9.CrossRefPubMedCentralPubMed
2.
Zurück zum Zitat Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10(5):459–66.CrossRefPubMed Stupp R, Hegi ME, Mason WP, van den Bent MJ, Taphoorn MJ, Janzer RC, et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol. 2009;10(5):459–66.CrossRefPubMed
3.
Zurück zum Zitat Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987–96.CrossRefPubMed Stupp R, Mason WP, van den Bent MJ, Weller M, Fisher B, Taphoorn MJ, et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med. 2005;352(10):987–96.CrossRefPubMed
4.
Zurück zum Zitat Yung WK, Albright RE, Olson J, Fredericks R, Fink K, Prados MD, et al. A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer. 2000;83(5):588–93.CrossRefPubMedCentralPubMed Yung WK, Albright RE, Olson J, Fredericks R, Fink K, Prados MD, et al. A phase II study of temozolomide vs. procarbazine in patients with glioblastoma multiforme at first relapse. Br J Cancer. 2000;83(5):588–93.CrossRefPubMedCentralPubMed
5.
Zurück zum Zitat Weller M, Cloughesy T, Perry JR, Wick W. Standards of care for treatment of recurrent glioblastoma—Are we there yet? Neuro-Oncology. 2013;15(1):4–27.CrossRefPubMedCentralPubMed Weller M, Cloughesy T, Perry JR, Wick W. Standards of care for treatment of recurrent glioblastoma—Are we there yet? Neuro-Oncology. 2013;15(1):4–27.CrossRefPubMedCentralPubMed
6.
Zurück zum Zitat Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9(6):669–76.CrossRefPubMed Ferrara N, Gerber HP, LeCouter J. The biology of VEGF and its receptors. Nat Med. 2003;9(6):669–76.CrossRefPubMed
7.
Zurück zum Zitat Godard S, Getz G, Delorenzi M, Farmer P, Kobayashi H, Desbaillets I, et al. Classification of human astrocytic gliomas on the basis of gene expression: a correlated group of genes with angiogenic activity emerges as a strong predictor of subtypes. Cancer Res. 2003;63(20):6613–25.PubMed Godard S, Getz G, Delorenzi M, Farmer P, Kobayashi H, Desbaillets I, et al. Classification of human astrocytic gliomas on the basis of gene expression: a correlated group of genes with angiogenic activity emerges as a strong predictor of subtypes. Cancer Res. 2003;63(20):6613–25.PubMed
8.
Zurück zum Zitat Jain HV, Nor JE, Jackson TL. Modeling the VEGF-Bcl-2-CXCL8 pathway in intratumoral angiogenesis. Bull Math Biol. 2008;70(1):89–117.CrossRefPubMed Jain HV, Nor JE, Jackson TL. Modeling the VEGF-Bcl-2-CXCL8 pathway in intratumoral angiogenesis. Bull Math Biol. 2008;70(1):89–117.CrossRefPubMed
9.
Zurück zum Zitat Fang Y, Qu X, Cheng B, Chen Y, Wang Z, Chen F, et al. The efficacy and safety of bevacizumab combined with chemotherapy in treatment of HER2-negative metastatic breast cancer: a meta-analysis based on published phase III trials. Tumour Biol. 2014. doi:10.1007/s13277-014-2799-7. Fang Y, Qu X, Cheng B, Chen Y, Wang Z, Chen F, et al. The efficacy and safety of bevacizumab combined with chemotherapy in treatment of HER2-negative metastatic breast cancer: a meta-analysis based on published phase III trials. Tumour Biol. 2014. doi:10.​1007/​s13277-014-2799-7.
10.
Zurück zum Zitat Lange A, Prenzler A, Frank M, Golpon H, Welte T, von der Schulenburg JM. A systematic review of the cost-effectiveness of targeted therapies for metastatic non-small cell lung cancer (NSCLC). BMC Pulm Med. 2014;14(1):192.CrossRefPubMedCentralPubMed Lange A, Prenzler A, Frank M, Golpon H, Welte T, von der Schulenburg JM. A systematic review of the cost-effectiveness of targeted therapies for metastatic non-small cell lung cancer (NSCLC). BMC Pulm Med. 2014;14(1):192.CrossRefPubMedCentralPubMed
11.
Zurück zum Zitat Kreisl TN, Kim L, Moore K, Duic P, Royce C, Stroud I, et al. Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol. 2009;27(5):740–5.CrossRefPubMedCentralPubMed Kreisl TN, Kim L, Moore K, Duic P, Royce C, Stroud I, et al. Phase II trial of single-agent bevacizumab followed by bevacizumab plus irinotecan at tumor progression in recurrent glioblastoma. J Clin Oncol. 2009;27(5):740–5.CrossRefPubMedCentralPubMed
12.
Zurück zum Zitat Chamberlain MC, Johnston SK. Salvage therapy with single agent bevacizumab for recurrent glioblastoma. J Neurooncol. 2010;96(2):259–69.CrossRefPubMed Chamberlain MC, Johnston SK. Salvage therapy with single agent bevacizumab for recurrent glioblastoma. J Neurooncol. 2010;96(2):259–69.CrossRefPubMed
13.
Zurück zum Zitat Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, Abrey LE, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol. 2009;27(28):4733–40.CrossRefPubMed Friedman HS, Prados MD, Wen PY, Mikkelsen T, Schiff D, Abrey LE, et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol. 2009;27(28):4733–40.CrossRefPubMed
14.
Zurück zum Zitat Cirillo M, Venturini M, Ciccarelli L, Coati F, Bortolami O, Verlato G. Clinician versus nurse symptom reporting using the National Cancer Institute—common terminology criteria for adverse events during chemotherapy: results of a comparison based on patient’s self-reported questionnaire. Ann Oncol. 2009;20(12):1929–35.CrossRefPubMed Cirillo M, Venturini M, Ciccarelli L, Coati F, Bortolami O, Verlato G. Clinician versus nurse symptom reporting using the National Cancer Institute—common terminology criteria for adverse events during chemotherapy: results of a comparison based on patient’s self-reported questionnaire. Ann Oncol. 2009;20(12):1929–35.CrossRefPubMed
15.
Zurück zum Zitat Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963–72.CrossRefPubMed Wen PY, Macdonald DR, Reardon DA, Cloughesy TF, Sorensen AG, Galanis E, et al. Updated response assessment criteria for high-grade gliomas: response assessment in neuro-oncology working group. J Clin Oncol. 2010;28(11):1963–72.CrossRefPubMed
16.
Zurück zum Zitat Jansen M, de Witt Hamer PC, Witmer AN, Troost D, van Noorden CJ. Current perspectives on antiangiogenesis strategies in the treatment of malignant gliomas. Brain Res Brain Res Rev. 2004;45(3):143–63.CrossRefPubMed Jansen M, de Witt Hamer PC, Witmer AN, Troost D, van Noorden CJ. Current perspectives on antiangiogenesis strategies in the treatment of malignant gliomas. Brain Res Brain Res Rev. 2004;45(3):143–63.CrossRefPubMed
17.
Zurück zum Zitat Huang H, Held-Feindt J, Buhl R, Mehdorn HM, Mentlein R. Expression of VEGF and its receptors in different brain tumors. Neurol Res. 2005;27(4):371–7.CrossRefPubMed Huang H, Held-Feindt J, Buhl R, Mehdorn HM, Mentlein R. Expression of VEGF and its receptors in different brain tumors. Neurol Res. 2005;27(4):371–7.CrossRefPubMed
18.
Zurück zum Zitat Jain RK. Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science. 2005;307(5706):58–62.CrossRefPubMed Jain RK. Normalization of tumor vasculature: an emerging concept in antiangiogenic therapy. Science. 2005;307(5706):58–62.CrossRefPubMed
19.
Zurück zum Zitat Cloughesy T, Prados M, Wen PY. A phase II, randomized, noncomparative clinical trial of bevacizumab alone or in combination with irinotecan prolongs 6-month PFS in recurrent, treatment-refractory glioblastoma [abstract]. J Clin Oncol. 2008;26:2010b. Cloughesy T, Prados M, Wen PY. A phase II, randomized, noncomparative clinical trial of bevacizumab alone or in combination with irinotecan prolongs 6-month PFS in recurrent, treatment-refractory glioblastoma [abstract]. J Clin Oncol. 2008;26:2010b.
20.
Zurück zum Zitat Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Marcello J, Reardon DA, Quinn JA, et al. Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol. 2007;25(30):4722–9.CrossRefPubMed Vredenburgh JJ, Desjardins A, Herndon JE 2nd, Marcello J, Reardon DA, Quinn JA, et al. Bevacizumab plus irinotecan in recurrent glioblastoma multiforme. J Clin Oncol. 2007;25(30):4722–9.CrossRefPubMed
21.
Zurück zum Zitat Pope WB, Lai A, Nghiemphu P, Mischel P, Cloughesy TF. MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy. Neurology. 2006;66(8):1258–60.CrossRefPubMed Pope WB, Lai A, Nghiemphu P, Mischel P, Cloughesy TF. MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy. Neurology. 2006;66(8):1258–60.CrossRefPubMed
22.
Zurück zum Zitat Nagane M, Nishikawa R, Narita Y, Kobayashi H, Takano S, Shinoura N, et al. Phase II study of single-agent bevacizumab in Japanese patients with recurrent malignant glioma. Jpn J Clin Oncol. 2012;42(10):887–95.CrossRefPubMedCentralPubMed Nagane M, Nishikawa R, Narita Y, Kobayashi H, Takano S, Shinoura N, et al. Phase II study of single-agent bevacizumab in Japanese patients with recurrent malignant glioma. Jpn J Clin Oncol. 2012;42(10):887–95.CrossRefPubMedCentralPubMed
23.
Zurück zum Zitat Nghiemphu PL, Liu W, Lee Y, Than T, Graham C, Lai A, et al. Bevacizumab and chemotherapy for recurrent glioblastoma: a single-institution experience. Neurology. 2009;72(14):1217–22.CrossRefPubMedCentralPubMed Nghiemphu PL, Liu W, Lee Y, Than T, Graham C, Lai A, et al. Bevacizumab and chemotherapy for recurrent glioblastoma: a single-institution experience. Neurology. 2009;72(14):1217–22.CrossRefPubMedCentralPubMed
24.
Zurück zum Zitat Francesconi AB, Dupre S, Matos M, Martin D, Hughes BG, Wyld DK, et al. Carboplatin and etoposide combined with bevacizumab for the treatment of recurrent glioblastoma multiforme. J Clin Neurosci. 2010;17(8):970–4.CrossRefPubMed Francesconi AB, Dupre S, Matos M, Martin D, Hughes BG, Wyld DK, et al. Carboplatin and etoposide combined with bevacizumab for the treatment of recurrent glioblastoma multiforme. J Clin Neurosci. 2010;17(8):970–4.CrossRefPubMed
25.
Zurück zum Zitat Hasselbalch B, Lassen U, Hansen S, Holmberg M, Sorensen M, Kosteljanetz M, et al. Cetuximab, bevacizumab, and irinotecan for patients with primary glioblastoma and progression after radiation therapy and temozolomide: a phase II trial. Neuro-Oncology. 2010;12(5):508–16.PubMedCentralPubMed Hasselbalch B, Lassen U, Hansen S, Holmberg M, Sorensen M, Kosteljanetz M, et al. Cetuximab, bevacizumab, and irinotecan for patients with primary glioblastoma and progression after radiation therapy and temozolomide: a phase II trial. Neuro-Oncology. 2010;12(5):508–16.PubMedCentralPubMed
26.
Zurück zum Zitat Sathornsumetee S, Desjardins A, Vredenburgh JJ, McLendon RE, Marcello J, Herndon JE, et al. Phase II trial of bevacizumab and erlotinib in patients with recurrent malignant glioma. Neuro-Oncology. 2010;12(12):1300–10.PubMedCentralPubMed Sathornsumetee S, Desjardins A, Vredenburgh JJ, McLendon RE, Marcello J, Herndon JE, et al. Phase II trial of bevacizumab and erlotinib in patients with recurrent malignant glioma. Neuro-Oncology. 2010;12(12):1300–10.PubMedCentralPubMed
27.
Zurück zum Zitat Verhoeff JJ, Lavini C, van Linde ME, Stalpers LJ, Majoie CB, Reijneveld JC, et al. Bevacizumab and dose-intense temozolomide in recurrent high-grade glioma. Ann Oncol. 2010;21(8):1723–7.CrossRefPubMed Verhoeff JJ, Lavini C, van Linde ME, Stalpers LJ, Majoie CB, Reijneveld JC, et al. Bevacizumab and dose-intense temozolomide in recurrent high-grade glioma. Ann Oncol. 2010;21(8):1723–7.CrossRefPubMed
28.
Zurück zum Zitat Desjardins A, Reardon DA, Coan A, Marcello J, Herndon JE 2nd, Bailey L, et al. Bevacizumab and daily temozolomide for recurrent glioblastoma. Cancer. 2012;118(5):1302–12.CrossRefPubMed Desjardins A, Reardon DA, Coan A, Marcello J, Herndon JE 2nd, Bailey L, et al. Bevacizumab and daily temozolomide for recurrent glioblastoma. Cancer. 2012;118(5):1302–12.CrossRefPubMed
29.
Zurück zum Zitat Reardon DA, Desjardins A, Peters KB, Gururangan S, Sampson JH, McLendon RE, et al. Phase II study of carboplatin, irinotecan, and bevacizumab for bevacizumab naive, recurrent glioblastoma. J Neurooncol. 2012;107(1):155–64.CrossRefPubMedCentralPubMed Reardon DA, Desjardins A, Peters KB, Gururangan S, Sampson JH, McLendon RE, et al. Phase II study of carboplatin, irinotecan, and bevacizumab for bevacizumab naive, recurrent glioblastoma. J Neurooncol. 2012;107(1):155–64.CrossRefPubMedCentralPubMed
30.
Zurück zum Zitat Raizer JJ, Grimm S, Chamberlain MC, Nicholas MK, Chandler JP, Muro K, et al. A phase 2 trial of single-agent bevacizumab given in an every-3-week schedule for patients with recurrent high-grade gliomas. Cancer. 2010;116(22):5297–305.CrossRefPubMed Raizer JJ, Grimm S, Chamberlain MC, Nicholas MK, Chandler JP, Muro K, et al. A phase 2 trial of single-agent bevacizumab given in an every-3-week schedule for patients with recurrent high-grade gliomas. Cancer. 2010;116(22):5297–305.CrossRefPubMed
31.
Zurück zum Zitat Zhang G, Huang S, Wang Z. A meta-analysis of bevacizumab alone and in combination with irinotecan in the treatment of patients with recurrent glioblastoma multiforme. J Clin Neurosci. 2012;19(12):1636–40.CrossRefPubMed Zhang G, Huang S, Wang Z. A meta-analysis of bevacizumab alone and in combination with irinotecan in the treatment of patients with recurrent glioblastoma multiforme. J Clin Neurosci. 2012;19(12):1636–40.CrossRefPubMed
Metadaten
Titel
Single-agent bevacizumab is an effective treatment in recurrent glioblastoma
verfasst von
Ilhan Hacibekiroglu
Hilmi Kodaz
Bulent Erdogan
Esma Turkmen
Melike Ozcelik
Asim Esenkaya
Haci Mehmet Saygi
Sernaz Uzunoglu
Irfan Cicin
Publikationsdatum
01.02.2015
Verlag
Springer US
Erschienen in
Medical Oncology / Ausgabe 2/2015
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI
https://doi.org/10.1007/s12032-014-0460-3

Weitere Artikel der Ausgabe 2/2015

Medical Oncology 2/2015 Zur Ausgabe

Adjuvante Immuntherapie verlängert Leben bei RCC

25.04.2024 Nierenkarzinom Nachrichten

Nun gibt es auch Resultate zum Gesamtüberleben: Eine adjuvante Pembrolizumab-Therapie konnte in einer Phase-3-Studie das Leben von Menschen mit Nierenzellkarzinom deutlich verlängern. Die Sterberate war im Vergleich zu Placebo um 38% geringer.

Alectinib verbessert krankheitsfreies Überleben bei ALK-positivem NSCLC

25.04.2024 NSCLC Nachrichten

Das Risiko für Rezidiv oder Tod von Patienten und Patientinnen mit reseziertem ALK-positivem NSCLC ist unter einer adjuvanten Therapie mit dem Tyrosinkinase-Inhibitor Alectinib signifikant geringer als unter platinbasierter Chemotherapie.

Bei Senioren mit Prostatakarzinom auf Anämie achten!

24.04.2024 DGIM 2024 Nachrichten

Patienten, die zur Behandlung ihres Prostatakarzinoms eine Androgendeprivationstherapie erhalten, entwickeln nicht selten eine Anämie. Wer ältere Patienten internistisch mitbetreut, sollte auf diese Nebenwirkung achten.

ICI-Therapie in der Schwangerschaft wird gut toleriert

Müssen sich Schwangere einer Krebstherapie unterziehen, rufen Immuncheckpointinhibitoren offenbar nicht mehr unerwünschte Wirkungen hervor als andere Mittel gegen Krebs.

Update Onkologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.