Clinical outcome with bevacizumab in patients with recurrent high-grade glioma treated outside clinical trials

Höfer, Silvia; Elandt, Katarzyna; Greil, Richard; Hottinger, Andreas F.; Huber, Urs; Lemke, Dieter; Marosi, Christine; Ochsenbein, Adrian F.; Pichler, Josef; Roelcke, Ulrich; Weder, Patrik; Zander, Thilo; Wick, Wolfgang; Weller, Michael

doi:10.3109/0284186x.2011.572913

Cited by 40 publications

(25 citation statements)

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“…Numerous phase II studies have shown modest survival benefits with bevacizumab either as a monotherapy or in combination with irinotecan (Chinot et al 2011;Jakobsen et al 2011;Lai et al 2011;Prados et al 2011;Reardon et al 2011). Consistent to all trials examining bevacizumab efficacy is the reduction of steroids for patients and valuable palliation with preservation of key performance status (KPS), supporting a role for bevacizumab as a therapy in late stage disease (Hofer et al 2011). …”

Section: Targeting Angiogenesismentioning

confidence: 97%

Biomarker Discovery, Validation and Clinical Application for Patients Diagnosed with Glioma

McDonald¹

2011

Glioma - Exploring Its Biology and Practical Relevance

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Section: Targeting Angiogenesismentioning

confidence: 97%

Biomarker Discovery, Validation and Clinical Application for Patients Diagnosed with Glioma

McDonald¹

2011

Glioma - Exploring Its Biology and Practical Relevance

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“…Treatment for recurrent GBM mainly comprises chemotherapy, which presents its own toxic side effects [7,11,12]. Repeated irradiation has been linked to higher complication rates [4,22,23,24].…”

Section: Discussionmentioning

confidence: 99%

“…Reoperation and retreatment with radiotherapy have been associated with increased complication and morbidity rates [8,9,10]. Treatment for recurrent GBM mainly comprises chemotherapy, which presents its own toxic side effects [7,11,12]. …”

Section: Introductionmentioning

confidence: 99%

Gamma Knife Radiosurgery in Recurrent Glioblastoma

Frischer

Marosi

Wöehrer³

et al. 2016

Stereotact Funct Neurosurg

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Background: We evaluated Gamma Knife radiosurgery (GKRS) as a treatment option for patients with recurrent glioblastoma. Patients and Methods: 42 patients with histopathologically diagnosed recurrent grade IV tumor were treated with GKRS. All patients had undergone standard multimodal first-line treatment. The average time from diagnosis to GKRS was 17.0 months. The median target volume was 5.1 cm³. The median margin dose was 10 Gy and the median central dose 20 Gy. In a subset of patients, O⁶-methylguanine methyltransferase (MGMT) promoter methylation analysis by pyrosequencing was performed. Results: Most patients did not develop complications after GKRS. Time to radiological progression after initial GKRS was 4.4 months (95% CI: 3.1-5.7 months). Radiological progression mainly occurred beyond the GKRS-irradiated area. The median survival time after initial GKRS was 9.6 months (95% CI: 7.7-11.5 months). The median overall survival time from diagnosis was 25.6 months (95% CI: 21.8-29.3 months). Patients with MGMT promoter methylation survived significantly longer (33.4 months; 95% CI: 21.2-45.5 months) compared to patients without MGMT promoter methylation (16.0 months; 95% CI: 8.0-23.9 months). Conclusion: GKRS seems to be a relatively safe salvage treatment option for recurrent glioblastoma for highly selected patients but must be seen as part of a multimodal treatment algorithm.

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“…Previous studies evaluating the efficacy of BEV monotherapy for patients with recurrent GBM have demonstrated objective RR (PR plus CR), overall survival, PFS and PFS-6 rates of 28.2-43%, 7.2-12 months, 1.0-4.2 months and 20.9-42.6%, respectively, as calculated from statistical treatment of the data (25)(26)(27)(29)(30)(31)(32)(33). Furthermore, BEV plus chemotherapy combination therapy increased RR and PFS (25,27), and additional studies of BEV in combination with cytotoxic agents including carboplatin, erlotinib, etoposide, fotemustine, CPT-11 and dose-intense daily TMZ for patients with recurrent GBM also demonstrated RR, OS, PFS and PFS-6 rates of 20-67.6%, 4.3-11.5 months, 2.5-7.6 months and 25-63.7%, respectively (Table I) (17).…”

Section: Efficacy Of Bevacizumab Treatment For Patients With Recurrenmentioning

confidence: 99%

Efficacy and safety of bevacizumab for the treatment of glioblastoma

Zhao

Zhang

et al. 2015

Experimental and Therapeutic Medicine

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Abstract. Glioblastoma (GBM) is the most common and devastating primary malignant intracranial tumor in adults. The current first-line treatment for patients with newly diagnosed GBM is surgical resection followed by radiotherapy plus concomitant and adjuvant temozolomide. This treatment protocol may prolong the survival period of the patient, however it is not curative and more effective therapeutic strategies are required. GBM is a type of highly vascularized tumor with increased expression levels of vascular endothelial growth factor (VEGF), which is a significant mediator of angiogenesis. Since angiogenesis is essential for tumor growth, anti-angiogenic therapies hold potential for the treatment of GBM, and targeting VEGF has demonstrated promising results in previous studies. Bevacizumab (BEV) is a recombinant humanized monoclonal antibody that inhibits VEGF and is approved by the US Food and Drug Administration as a monotherapy treatment for patients with recurrent GBM and is associated with manageable toxicity. Previous studies have demonstrated that BEV may be an effective treatment for recurrent GBM, with prolonged progression-free survival and overall survival, and maintained patient quality of life and functional status. The present review article briefly outlines the mechanism of action of BEV and summarizes the current literature and clinical trial research on the role of BEV for the treatment of patients with recurrent and newly diagnosed

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Clinical outcome with bevacizumab in patients with recurrent high-grade glioma treated outside clinical trials

Abstract: Our data reveal valuable palliation with preservation of KPS and an option for steroid withdrawal in patients treated with BEV, supporting the role of this therapy in late-stage disease.

Cited by 40 publications

References 14 publications

Biomarker Discovery, Validation and Clinical Application for Patients Diagnosed with Glioma

Biomarker Discovery, Validation and Clinical Application for Patients Diagnosed with Glioma

Gamma Knife Radiosurgery in Recurrent Glioblastoma

Efficacy and safety of bevacizumab for the treatment of glioblastoma

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