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Bevacizumab continuation beyond initial bevacizumab progression among recurrent glioblastoma patients.
MedLine Citation:
PMID:  23037712     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Bevacizumab improves outcome for most recurrent glioblastoma patients, but the duration of benefit is limited and survival after initial bevacizumab progression is poor. We evaluated bevacizumab continuation beyond initial progression among recurrent glioblastoma patients as it is a common, yet unsupported practice in some countries.
METHODS: We analysed outcome among all patients (n=99) who received subsequent therapy after progression on one of five consecutive, single-arm, phase II clinical trials evaluating bevacizumab regimens for recurrent glioblastoma. Of note, the five trials contained similar eligibility, treatment and assessment criteria, and achieved comparable outcome.
RESULTS: The median overall survival (OS) and OS at 6 months for patients who continued bevacizumab therapy (n=55) were 5.9 months (95% confidence interval (CI): 4.4, 7.6) and 49.2% (95% CI: 35.2, 61.8), compared with 4.0 months (95% CI: 2.1, 5.4) and 29.5% (95% CI: 17.0, 43.2) for patients treated with a non-bevacizumab regimen (n=44; P=0.014). Bevacizumab continuation was an independent predictor of improved OS (hazard ratio=0.64; P=0.04).
CONCLUSION: The results of our retrospective pooled analysis suggest that bevacizumab continuation beyond initial progression modestly improves survival compared with available non-bevacizumab therapy for recurrent glioblastoma patients require evaluation in an appropriately randomised, prospective trial.
Authors:
D A Reardon; J E Herndon; K B Peters; A Desjardins; A Coan; E Lou; A L Sumrall; S Turner; E S Lipp; S Sathornsumetee; J N Rich; J H Sampson; A H Friedman; S T Boulton; D D Bigner; H S Friedman; J J Vredenburgh
Publication Detail:
Type:  Clinical Trial, Phase II; Journal Article; Research Support, N.I.H., Extramural     Date:  2012-10-04
Journal Detail:
Title:  British journal of cancer     Volume:  107     ISSN:  1532-1827     ISO Abbreviation:  Br. J. Cancer     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-10-24     Completed Date:  2013-03-21     Revised Date:  2013-04-16    
Medline Journal Info:
Nlm Unique ID:  0370635     Medline TA:  Br J Cancer     Country:  England    
Other Details:
Languages:  eng     Pagination:  1481-7     Citation Subset:  IM    
Affiliation:
Department of Surgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, 200 Trent Drive, Durham, NC 27710, USA. dreardon3@partners.org
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiogenesis Inhibitors / administration & dosage*,  adverse effects
Antibodies, Monoclonal, Humanized / administration & dosage*,  adverse effects
Brain Neoplasms / drug therapy*
Disease Progression
Drug Administration Schedule
Glioblastoma / drug therapy*
Humans
Middle Aged
Neoplasm Recurrence, Local / drug therapy*
Retrospective Studies
Survival Analysis
Treatment Outcome
Young Adult
Grant Support
ID/Acronym/Agency:
5 R37 CA11898/CA/NCI NIH HHS; 5P50-NS-20023/NS/NINDS NIH HHS; MO1 RR 30/RR/NCRR NIH HHS
Chemical
Reg. No./Substance:
0/Angiogenesis Inhibitors; 0/Antibodies, Monoclonal, Humanized; 0/bevacizumab

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