This article is more than 5 years old. Information may no longer be current.
Bevacizumab delayed progression in recurrent brain tumors
Click Here to Manage Email Alerts
In a retrospective study, bevacizumab extended PFS for patients with recurrent alkylator-refractory anaplastic oligodendroglioma.
Researchers reviewed the cases of 22 patients with recurrent alkylator-refractory 1p19q codeleted anaplastic oligodendroglioma who had previously been treated with surgery, radiotherapy and/or adjuvant chemotherapy. One patient underwent a salvage regimen. At second recurrence, all were treated with bevacizumab (Avastin, Genentech).
Six patients had disease progression after two cycles and discontinued the trial. Fifteen other patients received at least 13 cycles of chemotherapy and all patients have since died of disease progression.
Median PFS was eight months (95% CI, 7.03-8.97) and ranged from three months to 18 months. OS ranged from three months to 19 months with an estimated median of eight months (95% CI, 6.28-9.72). The probability of survival at six months was 68% and 23% at 12 months.
No patient had complete response, but 14 (64%) demonstrated a neuroradiographic partial response (95% CI, 44%-84%). One patient had stable disease.
The researchers observed nine incidences of grade-3 adverse events. There were no reported incidences of grade-4 or -5 toxicities.
The researchers called the lack of an OS benefit “problematic” but said the results showed that bevacizumab should be evaluated in a prospective trial for quality-of-life endpoints and traditional outcome measures. – by Jason Harris
Chamberlain MC. Cancer. 2009;doi:10.1002/cncr.24179.
The results suggest there is quite a high response rate, consistent with
what we have seen in other anaplastic gliomas in publications from Duke and
elsewhere. There is clearly a very good radiographic response rate, better than
what we have seen from other agents with these tumors. The six-month PFS also
seems to be quite good. As Dr. Chamberlin himself notes, OS was relatively
disappointing and he acknowledges that further studies will be required to
determine how important a treatment modality this is for anaplastic
oligodendroglioma tumors. That said, de facto results that have already been
published in tumors that are typically less responsive to chemotherapy,
specifically glioblastomas and anaplastic astrocytomas, have already indicated
a role for bevacizumab in this type of tumor. 
Click
here to hear perspective from Dr. Schiff.
– David Schiff, MD
Co-director of the University of Virginia Health System Neuro-Oncology Center, Charlottesville