Bevacizumab plus irinotecan in recurrent glioblastoma multiforme
- PMID: 17947719
- DOI: 10.1200/JCO.2007.12.2440
Bevacizumab plus irinotecan in recurrent glioblastoma multiforme
Abstract
Purpose: The prognosis for patients with recurrent glioblastoma multiforme is poor, with a median survival of 3 to 6 months. We performed a phase II trial of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in combination with irinotecan.
Patients and methods: This phase II trial included two cohorts of patients. The initial cohort, comprising 23 patients, received bevacizumab at 10 mg/kg plus irinotecan every 2 weeks. The dose of irinotecan was based on the patient's anticonvulsant: Patients taking enzyme-inducing antiepileptic drugs (EIAEDs) received 340 mg/m2, and patients not taking EIAEDs received 125 mg/m2. After this regimen was deemed safe and effective, the irinotecan schedule was changed to an accepted brain tumor regimen of four doses in 6 weeks, in anticipation of a phase III randomized trial of irinotecan versus irinotecan and bevacizumab. The second cohort, comprising 12 patients, received bevacizumab 15 mg/kg every 21 days and irinotecan on days 1, 8, 22, and 29. Each cycle was 6 weeks long and concluded with patient evaluations, including magnetic resonance imaging.
Results: The 6-month progression-free survival among all 35 patients was 46% (95% CI, 32% to 66%). The 6-month overall survival was 77% (95% CI, 64% to 92%). Twenty of the 35 patients (57%; 95% CI, 39% to 74%) had at least a partial response. One patient developed a CNS hemorrhage, which occurred in his 10th cycle. Four patients developed thromboembolic complications (deep venous thrombosis and/or pulmonary emboli).
Conclusion: Bevacizumab and irinotecan is an effective treatment for recurrent glioblastoma multiforme and has moderate toxicity.
Comment in
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Taming glioblastoma: targeting angiogenesis.J Clin Oncol. 2007 Oct 20;25(30):4705-6. doi: 10.1200/JCO.2007.13.1037. J Clin Oncol. 2007. PMID: 17947716 No abstract available.
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Bevacizumab combined with irinotecan for recurrent glioblastoma multiforme--improvement over available therapy?Nat Clin Pract Neurol. 2008 May;4(5):242-3. doi: 10.1038/ncpneuro0712. Epub 2008 Jan 22. Nat Clin Pract Neurol. 2008. PMID: 18212790 No abstract available.
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Bevacizumab plus irinotecan in recurrent glioblastoma.J Clin Oncol. 2008 Feb 20;26(6):1012-3; author reply 1013. doi: 10.1200/JCO.2007.15.1605. J Clin Oncol. 2008. PMID: 18281677 No abstract available.
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Bevacizumab in combination with irinotecan for patients with recurrent glioblastoma multiforme.Nat Clin Pract Oncol. 2008 Apr;5(4):186-7. doi: 10.1038/ncponc1077. Epub 2008 Feb 19. Nat Clin Pract Oncol. 2008. PMID: 18285760 No abstract available.
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Fewer dollars, more sense.J Clin Oncol. 2008 Nov 10;26(32):5304-5; author reply 5305. doi: 10.1200/JCO.2008.17.9564. Epub 2008 Oct 14. J Clin Oncol. 2008. PMID: 18854564 No abstract available.
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