Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Jul 18:13:1212714.
doi: 10.3389/fonc.2023.1212714. eCollection 2023.

Bevacizumab in recurrent WHO grades II-III glioma

Soufyan Annakib  1   2 , Valérie Rigau  3   4 , Amélie Darlix  1   4 , Catherine Gozé  3   4   5 , Hugues Duffau  4   6 , Luc Bauchet  4   6 , Marta Jarlier  7 , Michel Fabbro  1
Affiliations

Bevacizumab in recurrent WHO grades II-III glioma

Soufyan Annakib et al. Front Oncol. .

Abstract

Purpose: The management of recurrent WHO grades II-III (rGII-III) glioma is not well established. This study describes the clinical outcomes in patients who received bevacizumab as rescue treatment.

Methods: In this retrospective study, the main inclusion criteria were as follows: adult patients with histologicaly proved rGII-III glioma according 2016 WHO classification treated with bevacizumab from 2011 to 2019, T1 contrast enhancement on MRI. Efficacy was assessed using the high-grade glioma 2017 Response Assessment in Neuro-Oncology criteria. Progression-free survival (PFS) and overall survival (OS) were estimated using the Kaplan-Meier method.

Results: Eighty-one patients were included (M/F ratio: 1.7, median age at diagnosis: 38 years) among whom 46 (56.8%) had an initial diagnosis of grade II glioma. Previous treatments included at least one surgical intervention, radiotherapy (98.8%), and ≥ 2 chemotherapy lines (64.2%). After bevacizumab initiation, partial response, stable disease, and progressive disease were observed in 27.2%, 22.2%, and 50.6% of patients. The median PFS and OS were 4.9 months (95% confidence interval [CI] 3.7-6.1) and 7.6 months (95% CI 5.5-9.9). Bevacizumab severe toxicity occurred in 12.3%. Twenty-four (29.6%) patients discontinued bevacizumab without radiological progression. Oligodendroglioma and age ≥ 38 years at diagnosis were more frequent in this subgroup (odds ratio = 0.24, 95% CI 0.07-0.84, p = 0.023 and 0.36, 95% CI 0.13-0.99, p = 0.042). Ten of these 24 patients were alive at 12 months and two patients at 8 years after bevacizumab initiation, without any subsequent treatment.

Conclusion: Bevacizumab can be an option for heavily pretreated patients with rGII-III glioma with contrast enhancement. In our study, bevacizumab displayed prolonged activity in a subgroup of patients.

Keywords: anaplastic glioma; astrocytoma; bevacizumab; oligodendroglioma; recurrent glioma; transformed low grade glioma.

PubMed Disclaimer

Conflict of interest statement

HD is an Integra speaker’s bureau member. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Kaplan–Meier analysis of survival in patients with recurrent grade II or III glioma on bevacizumab. (A) Progression-free survival (PFS) and (B) overall survival (OS) since bevacizumab initiation (whole sample; n = 81); (C) OS since bevacizumab initiation according to the WHO histological grade (whole samples); (D) OS since bevacizumab initiation of the 24 patients who discontinued treatment without radiological progression.
Figure 2
Figure 2
Survival since bevacizumab initiation in patients who discontinued bevacizumab without radiological progression (n = 24). Each bar corresponds to one patient. Bar length indicates the patient’s overall survival from bevacizumab initiation to death or last follow-up. Best response: stable disease or partial response.
See this image and copyright information in PMC

References

    1. Bauchet L, Ostrom QT. Epidemiology and molecular epidemiology. Neurosurg Clinics North America (2019) 30:1–16. doi: 10.1016/j.nec.2018.08.010 - DOI - PubMed
    1. Ostrom QT, Price M, Neff C, Cioffi G, Waite KA, Kruchko C, et al. . CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the united states in 2015–2019. Neuro-Oncology (2022) 24:v1–v95. doi: 10.1093/neuonc/noac202 - DOI - PMC - PubMed
    1. Darlix A, Zouaoui S, Virion J-M, Rigau V, Mathieu-Daudé H, Blonski M, et al. . Significant heterogeneity in the geographical distribution of diffuse grade II/III gliomas in France. J Neurooncol (2014) 120:547–55. doi: 10.1007/s11060-014-1585-0 - DOI - PubMed
    1. Louis DN, Perry A, Reifenberger G, von Deimling A, Figarella-Branger D, Cavenee WK, et al. . The 2016 world health organization classification of tumors of the central nervous system: a summary. Acta Neuropathol (2016) 131:803–20. doi: 10.1007/s00401-016-1545-1 - DOI - PubMed
    1. Duffau H, Taillandier L. New concepts in the management of diffuse low-grade glioma: proposal of a multistage and individualized therapeutic approach. Neuro-Oncology (2014) 17(3):nou153. doi: 10.1093/neuonc/nou153 - DOI - PMC - PubMed

LinkOut - more resources