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. 2026 Feb 14.
doi: 10.1186/s12885-026-15725-9. Online ahead of print.

Evaluation of the efficacy and tolerability of bevacizumab-based treatments in recurrent primary brain tumors: a multicenter real-world Turkish Oncology Group (TOG) study

Zehra Sucuoğlu İşleyen  1 , Şaban Seçmeler  2 , Abdullah Sakin  3 , Şener Cihan  4 , Mehmet Beşiroğlu  5 , Seda Kahraman  6 , Melek Karakurt Eryılmaz  7 , Esra Zeynelgil  8 , Eda Çalışkan Yıldırım  9 , Engin Kut  10 , Nilay Şengül  11 , Fatma Paksoy Türköz  12 , Özkan Alan  13 , Özlem Özkul  14 , Selver Işık  15 , Feride Yılmaz  16 , Ahmet Gülmez  17 , Sema Türker  18 , Gökhan Karakaya  19 , Meral Günaldı  20 , Leyla Özer  21 , Asude Aksoy  22 , Fatih Karataş  23 , Teoman Sakalar  24 , Derya Demirtaş Esmer  25 , Fatih Teker  26 , Necla Demir  27 , Özgecan Dülgar  28 , Serdar Turhal  29 , Hacı Mehmet Türk  30 , Kayhan Ertürk  31 , Emir Çelik  32 , M Mustafa Atcı  32
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Free article

Evaluation of the efficacy and tolerability of bevacizumab-based treatments in recurrent primary brain tumors: a multicenter real-world Turkish Oncology Group (TOG) study

Zehra Sucuoğlu İşleyen et al. BMC Cancer. .
Free article

Abstract

Background: Bevacizumab is widely used for recurrent high-grade glioma, but the real-world effectiveness of bevacizumab with or without irinotecan remains uncertain. We evaluated outcomes of bevacizumab-based regimens in a large multicenter Turkish cohort.

Methods: In this retrospective study from 30 centers, adults with recurrent glioblastoma or other primary brain tumors treated with a bevacizumab-containing regimen at first or second progression were included. Patients received bevacizumab monotherapy, bevacizumab plus low-dose weekly irinotecan, or bevacizumab plus standard-dose irinotecan every 14 days. Tumor response, progression-free survival (PFS), overall survival (OS), and toxicity were assessed. Prognostic factors were analyzed using Cox regression.

Results: A total of 437 patients were included; 78.0% had glioblastoma. Treatment consisted of bevacizumab monotherapy in 9.4%, bevacizumab plus weekly irinotecan in 8.5%, and bevacizumab plus irinotecan every 14 days in 82.2% of patients. The objective response rate was 41.6%, and the disease control rate was 80.1%. Median OS was 10.77, 7.37 and 9.77 months (log-rank p = 0.024), and median PFS was 5.77, 3.93 and 6.43 months (p = 0.005), respectively. On multivariable analysis, glioblastoma histology independently predicted shorter PFS and OS, whereas a higher number of treatment cycles and antiepileptic drug use were associated with longer PFS. For OS, the irinotecan-bevacizumab every-14-day regimen and a higher number of treatment cycles were associated with improved survival compared with bevacizumab monotherapy, while baseline corticosteroid use and discontinuation of bevacizumab-containing therapy were independent adverse prognostic factors.

Conclusions: In this large real-world cohort, bevacizumab-based therapy achieved meaningful disease control and survival in recurrent primary brain tumors. An irinotecan-bevacizumab regimen administered every 14 days was associated with superior OS at the expense of increased but manageable chemotherapy-related toxicity, supporting its use in appropriately selected patients.

Keywords: Anti-VEGF therapy; Bevacizumab; Irinotecan; Recurrent glioblastoma.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: The study was approved by the Prof. Dr. Cemil Taşcıoğlu City Hospital Clinical Research Ethics Committee (approval number: 48670771-514.10). The requirement for informed consent was waived due to the retrospective and anonymized nature of the data. All study procedures were conducted in accordance with the ethical standards of the Declaration of Helsinki and its later amendments. Consent for publication: All authors agree to publish. Competing interests: The authors declare no competing interests.

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