Back to Search
Start Over
Implications of bevacizumab discontinuation in adults with recurrent glioblastoma.
- Source :
-
Neuro-oncology [Neuro Oncol] 2014 Jun; Vol. 16 (6), pp. 823-8. Date of Electronic Publication: 2014 Mar 03. - Publication Year :
- 2014
-
Abstract
- Background: Patients with recurrent glioblastoma benefiting from bevacizumab are often treated indefinitely due to concerns regarding rebound tumor recurrence upon discontinuation. However, treatment is discontinued for reasons other than disease progression in a subset of these patients, the characteristics and outcomes of which are poorly defined.<br />Methods: Of 342 adults with recurrent glioblastoma in our database treated with bevacizumab, 82 received treatment for ≥ 6 months; of these, bevacizumab was discontinued for reasons other than tumor progression in 18 patients (Bev-D) and for disease progression in the remainder (Bev-S). The impact of discontinuation on outcome was assessed with discontinuation as a time-dependent covariate in a Cox hazards model for progression-free survival.<br />Results: There was no difference in hazard rates for progression between Bev-D and Bev-S groups; the adjusted hazard ratio for progression using discontinuation as a time-dependent covariate was 0.91 (95% CI:0.47, 1.78). The median PFS after bevacizumab-discontinuation was 27 weeks (95% CI:15-NR). At progression, a higher proportion of Bev-D patients had local progression compared with the Bev-S patients. Salvage therapy in Bev-D patients yielded a PFS-26 weeks of 47% (95% CI:23%-94%) with a median PFS of 23 weeks (95% CI:12-NR), vs. 5% (95% CI: 1%-21%) and 9 weeks (95% CI: 6-11) in Bev-S patients (HR:0.3;CI, 0.1-0.6) (P = .0007).<br />Conclusions: Bevacizumab discontinuation unrelated to disease progression does not appear to cause rebound recurrence or worsen PFS in patients who benefit from bevacizumab. Additionally, Bev-D patients had an improved response to salvage therapy, findings which provide a strong basis for a prospective study.<br /> (© The Author(s) 2014. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)
- Subjects :
- Adult
Aged
Bevacizumab
Disease-Free Survival
Female
Humans
Male
Middle Aged
Treatment Outcome
Angiogenesis Inhibitors therapeutic use
Antibodies, Monoclonal, Humanized therapeutic use
Brain Neoplasms drug therapy
Disease Progression
Glioblastoma drug therapy
Neoplasm Recurrence, Local drug therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1523-5866
- Volume :
- 16
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Neuro-oncology
- Publication Type :
- Academic Journal
- Accession number :
- 24596117
- Full Text :
- https://doi.org/10.1093/neuonc/nou021