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. 2019 Feb 13;2(4):e114.
doi: 10.1002/hsr2.114. eCollection 2019 Apr.

Single-institution retrospective review of patients with recurrent glioblastoma treated with bevacizumab in clinical practice

Annick Desjardins  1 , James E Herndon 2nd  2   3 , Frances McSherry  3 , Arliene Ravelo  4 , Eric S Lipp  1 , Patrick Healy  3 , Katherine B Peters  1 , John H Sampson  1 , Dina Randazzo  1 , Nicolas Sommer  4 , Allan H Friedman  1 , Henry S Friedman  1
Affiliations

Single-institution retrospective review of patients with recurrent glioblastoma treated with bevacizumab in clinical practice

Annick Desjardins et al. Health Sci Rep. .

Abstract

Background and aims: This retrospective review of patients with recurrent glioblastoma treated at the Preston Robert Tisch Brain Tumor Center investigated treatment patterns, survival, and safety with bevacizumab in a real-world setting.

Methods: Adult patients with glioblastoma who initiated bevacizumab at disease progression between January 1, 2009, and May 14, 2012, were included. A Kaplan-Meier estimator was used to describe overall survival (OS), progression-free survival (PFS), and time to greater than or equal to 20% reduction in Karnofsky Performance Status (KPS). The effect of baseline demographic and clinical factors on survival was examined using a Cox proportional hazards model. Adverse event (AE) data were collected.

Results: Seventy-four patients, with a median age of 59 years, were included in this cohort. Between bevacizumab initiation and first failure, defined as the first disease progression after bevacizumab initiation, biweekly bevacizumab and bevacizumab/irinotecan were the most frequently prescribed regimens. Median duration of bevacizumab treatment until failure was 6.4 months (range, 0.5-58.7). Median OS and PFS from bevacizumab initiation were 11.1 months (95% confidence interval [CI], 7.3-13.4) and 6.4 months (95% CI, 3.9-8.5), respectively. Median time to greater than or equal to 20% reduction in KPS was 29.3 months (95% CI, 13.8-∞). Lack of corticosteroid usage at the start of bevacizumab therapy was associated with both longer OS and PFS, with a median OS of 13.2 months (95% CI, 8.6-16.6) in patients who did not initially require corticosteroids versus 7.2 months (95% CI, 4.8-12.5) in those who did (P = 0.0382, log-rank), while median PFS values were 8.6 months (95% CI, 4.6-9.7) and 3.7 months (95% CI, 2.7-6.6), respectively (P = 0.0243, log-rank). Treatment failure occurred in 70 patients; 47 of whom received salvage therapy, and most frequently bevacizumab/carboplatin (7/47; 14.9%). Thirteen patients (18%) experienced a grade 3 AE of special interest for bevacizumab.

Conclusions: Treatment patterns and outcomes for patients with recurrent glioblastoma receiving bevacizumab in a real-world setting were comparable with those reported in prospective clinical trials.

Keywords: bevacizumab; real‐world setting; recurrent glioblastoma; survival; treatment patterns.

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Conflict of interest statement

Annick Desjardins has received grants or research support from Genentech, PTC Therapeutics, Celldex, Triphase Research and Development Corp, Eli Lilly and Co, Eisai, Symphogen A/S, Pfizer, and Orbus Therapeutic and is an advisory board member for Genentech; Arliene Ravelo is an employee of Genentech and owns stock options in Roche; Nicolas Sommer is an employee of Genentech and owns stock options in Roche; and the remaining authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Kaplan‐Meier curves of: A, overall survival from initiation of bevacizumab; B, overall survival from glioblastoma diagnosis; and C, progression‐free survival from initiation of bevacizumab. CI indicates confidence interval; OS, overall survival; PFS, progression‐free survival
Figure 2
Figure 2
Time to a greater than or equal to 20% reduction in KPS from initiation of bevacizumab‐based treatment. *Thirteen patients were missing their baseline and/or their post‐baseline KPS. CI indicates confidence interval; KPS, Karnofsky performance status
Figure 3
Figure 3
Patterns of treatment until bevacizumab failure
See this image and copyright information in PMC

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