Third-line therapy in recurrent glioblastoma: is it another chance for bevacizumab?
| Autor: | Giuseppe Lamberti, Raffaele Agati, Enrico Franceschi, Antonella Mura, Stefania Bartolini, Alexandro Paccapelo, Giovenzio Genestreti, Monica Di Battista, S. Minichillo, Alba A. Brandes |
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| Rok vydání: | 2017 |
| Předmět: |
Oncology
Male Cancer Research Nitrosourea medicine.medical_treatment chemistry.chemical_compound 0302 clinical medicine Antineoplastic Agents Immunological DNA Modification Methylases Etoposide Brain Neoplasms Middle Aged Bevacizumab Treatment Outcome Neurology 030220 oncology & carcinogenesis Retreatment Quinolines Female medicine.drug Adult medicine.medical_specialty 03 medical and health sciences Young Adult Internal medicine medicine Biomarkers Tumor Humans Pyrroles Progression-free survival Survival analysis Aged Chemotherapy Temozolomide business.industry Tumor Suppressor Proteins DNA Methylation Survival Analysis Carboplatin DNA Repair Enzymes chemistry Acetanilides Neurology (clinical) Neoplasm Recurrence Local business Glioblastoma 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of neuro-oncology. 139(2) |
| ISSN: | 1573-7373 |
| Popis: | Standard glioblastoma therapy is long-lasting. Among second-line therapy, choices could be bevacizumab and nitrosoureas depending on National Agencies approval. There is no consensus on 3rd line therapy or clinical trials specifically designed for this setting. We reviewed our institutional database on all consecutive patients who received 3rd line therapy for glioblastoma. Data on 168 out of 1337 (12.6%) glioblastoma patients who underwent 3rd line therapy treatment were collected. Third line treatments were bevacizumab or chemotherapy (nitrosourea, temozolomide or carboplatin plus etoposide). Median progression free survival was 2.9 months and median survival time was 6.6 months from the start of 3rd line therapy. Bevacizumab significantly improved progression-free survival (4.7 vs. 2.6 months, p = .020) and survival from 3rd line start (8.0 vs. 6.0 months, p = .014) in respect to chemotherapy. Toxicity of grade ≥ 3 occurred in 13.7% of patients. In multivariate analysis, survival in 3rd line treatment depends on MGMT methylation (p = .006) and treatment with Bevacizumab (p = .011). Third line therapy in selected glioblastoma patients may be feasible and well tolerated. Bevacizumab improved outcome in 3rd line in respect to chemotherapy. |
| Databáze: | OpenAIRE |
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