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18.04.2018 | Clinical Study

Third-line therapy in recurrent glioblastoma: is it another chance for bevacizumab?

verfasst von: Enrico Franceschi, Giuseppe Lamberti, Alexandro Paccapelo, Monica Di Battista, Giovenzio Genestreti, Santino Minichillo, Antonella Mura, Stefania Bartolini, Raffaele Agati, Alba A. Brandes

Erschienen in: Journal of Neuro-Oncology | Ausgabe 2/2018

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Abstract

Background

Standard glioblastoma therapy is long-lasting. Among second-line therapy, choices could be bevacizumab and nitrosoureas depending on National Agencies approval. There is no consensus on 3rd line therapy or clinical trials specifically designed for this setting.

Methods

We reviewed our institutional database on all consecutive patients who received 3rd line therapy for glioblastoma.

Results

Data on 168 out of 1337 (12.6%) glioblastoma patients who underwent 3rd line therapy treatment were collected. Third line treatments were bevacizumab or chemotherapy (nitrosourea, temozolomide or carboplatin plus etoposide). Median progression free survival was 2.9 months and median survival time was 6.6 months from the start of 3rd line therapy. Bevacizumab significantly improved progression-free survival (4.7 vs. 2.6 months, p = .020) and survival from 3rd line start (8.0 vs. 6.0 months, p = .014) in respect to chemotherapy. Toxicity of grade ≥ 3 occurred in 13.7% of patients. In multivariate analysis, survival in 3rd line treatment depends on MGMT methylation (p = .006) and treatment with Bevacizumab (p = .011).

Conclusions

Third line therapy in selected glioblastoma patients may be feasible and well tolerated. Bevacizumab improved outcome in 3rd line in respect to chemotherapy.

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Titel: Third-line therapy in recurrent glioblastoma: is it another chance for bevacizumab?
verfasst von: Enrico Franceschi
Giuseppe Lamberti
Alexandro Paccapelo
Monica Di Battista
Giovenzio Genestreti
Santino Minichillo
Antonella Mura
Stefania Bartolini
Raffaele Agati
Alba A. Brandes
Publikationsdatum: 18.04.2018
Verlag: Springer US
Erschienen in: Journal of Neuro-Oncology / Ausgabe 2/2018
Print ISSN: 0167-594X
Elektronische ISSN: 1573-7373
DOI: https://doi.org/10.1007/s11060-018-2873-x

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Third-line therapy in recurrent glioblastoma: is it another chance for bevacizumab?