TY - JOUR
T1 - Prognostic factors in recurrent glioblastoma patients treated with bevacizumab
AU - Schaub, Christina
AU - Tichy, Julia
AU - Schäfer, Niklas
AU - Franz, Kea
AU - Mack, Frederic
AU - Mittelbronn, Michel
AU - Kebir, Sied
AU - Thiepold, Anna Luisa
AU - Waha, Andreas
AU - Filmann, Natalie
AU - Banat, Mohammed
AU - Fimmers, Rolf
AU - Steinbach, Joachim P.
AU - Herrlinger, Ulrich
AU - Rieger, Johannes
AU - Glas, Martin
AU - Bähr, Oliver
N1 - Publisher Copyright:
© 2016, Springer Science+Business Media New York.
PY - 2016/8/1
Y1 - 2016/8/1
N2 - The value of bevacizumab (BEV) in recurrent glioblastoma is unclear. Imaging parameters and progression-free survival (PFS) are problematic endpoints. Few data exist on clinical factors influencing overall survival (OS) in unselected patients with recurrent glioblastoma exposed to BEV. We retrospectively analyzed 174 patients with recurrent glioblastoma treated with BEV at two German brain tumor centers. We evaluated general patient characteristics, MGMT status, pretreatment, concomitant oncologic treatment and overall survival. Karnofsky performance score, number of prior chemotherapies, number of prior recurrences and combined treatment with irinotecan (IRI) were significantly associated with OS in univariate analysis. We did not find differences in OS related to sex, age, histology, MGMT status, prior surgical treatment or number of prior radiotherapies. Combined treatment with IRI and higher KPS both remained significantly associated with prolonged survival in multivariate analysis, but patients receiving IRI co-treatment had less advanced disease. Grouping into clinically relevant categories revealed an OS of 16.9 months from start of BEV in patients with first recurrence and KPS ≥ 80 % (n = 25). In contrast, in patients with second recurrence and KPS < 80 %, OS was 3.6 months (n = 27). Our observational data support an early use of BEV in patients with good performance status. The benefit of co-treatment with IRI in our cohort seems to be the result of biased patient recruitment.
AB - The value of bevacizumab (BEV) in recurrent glioblastoma is unclear. Imaging parameters and progression-free survival (PFS) are problematic endpoints. Few data exist on clinical factors influencing overall survival (OS) in unselected patients with recurrent glioblastoma exposed to BEV. We retrospectively analyzed 174 patients with recurrent glioblastoma treated with BEV at two German brain tumor centers. We evaluated general patient characteristics, MGMT status, pretreatment, concomitant oncologic treatment and overall survival. Karnofsky performance score, number of prior chemotherapies, number of prior recurrences and combined treatment with irinotecan (IRI) were significantly associated with OS in univariate analysis. We did not find differences in OS related to sex, age, histology, MGMT status, prior surgical treatment or number of prior radiotherapies. Combined treatment with IRI and higher KPS both remained significantly associated with prolonged survival in multivariate analysis, but patients receiving IRI co-treatment had less advanced disease. Grouping into clinically relevant categories revealed an OS of 16.9 months from start of BEV in patients with first recurrence and KPS ≥ 80 % (n = 25). In contrast, in patients with second recurrence and KPS < 80 %, OS was 3.6 months (n = 27). Our observational data support an early use of BEV in patients with good performance status. The benefit of co-treatment with IRI in our cohort seems to be the result of biased patient recruitment.
KW - Bevacizumab
KW - Irinotecan
KW - Karnofsky performance score
KW - Recurrent glioblastoma
KW - Survival
UR - http://www.scopus.com/inward/record.url?scp=84969872697&partnerID=8YFLogxK
U2 - 10.1007/s11060-016-2144-7
DO - 10.1007/s11060-016-2144-7
M3 - Article
C2 - 27193554
AN - SCOPUS:84969872697
SN - 0167-594X
VL - 129
SP - 93
EP - 100
JO - Journal of Neuro-Oncology
JF - Journal of Neuro-Oncology
IS - 1
ER -