Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas
Abstract Background There is no consensus therapy recommended for recurrent malignant gliomas (MGs). In 2009, Bevacizumab (BEV) was approved by the FDA as single-agent for recurrent glioblastoma (GBM). The aim of this retrospective study was to evaluate the efficacy and the safety of BEV alone or in...
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| Format: | Article |
| Language: | English |
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BMC
2018-04-01
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| Series: | Translational Medicine Communications |
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| Online Access: | http://link.springer.com/article/10.1186/s41231-018-0023-2 |
| _version_ | 1819059943163035648 |
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| author | Arsela Prelaj Sara Elena Rebuzzi Maurizio Salvati Silvia Pecorari Chiara Pozzi Carmela Fusto Carla Ferrara Silverio Tomao Vincenzo Bianco |
| author_facet | Arsela Prelaj Sara Elena Rebuzzi Maurizio Salvati Silvia Pecorari Chiara Pozzi Carmela Fusto Carla Ferrara Silverio Tomao Vincenzo Bianco |
| author_sort | Arsela Prelaj |
| collection | DOAJ |
| description | Abstract Background There is no consensus therapy recommended for recurrent malignant gliomas (MGs). In 2009, Bevacizumab (BEV) was approved by the FDA as single-agent for recurrent glioblastoma (GBM). The aim of this retrospective study was to evaluate the efficacy and the safety of BEV alone or in combination with Fotemustine (FTM) in recurrent MGs. This represents an interim analysis of a larger study on BEV in MGs patients. Methods We analyzed 17 recurrent MGs patients, 12 GBM (70.6%) and 5 anaplastic gliomas (29.4%), underwent first-line therapy with Stupp regimen. BEV was administered as off-label therapy, at a dose of 10 mg/kg every 14 days, in 13 patients as third-line therapy and in 4 patients as second-line therapy associated with FTM. The assessment of MGMT methylation and IDH1 mutation was conducted. Results One complete response (5.9%), 7 partial responses (41.2%), 3 stable diseases (17.6%) and 6 progression diseases (35.3%) were assessed using RANO criteria. Median PFS (mPFS) and OS (mOS) were 5 and 8.3 months respectively, with a 6 months-PFS of 41.2%. Methylated patients and wild-type IDH1 patients showed longer mPFS and mOS without statistical significance. Six patients (35.3%) experienced long response with high number of cycles (11-40), long PFS (11-40 months) and OS (12-42 months). BEV was well-tolerated with grade 1-2 proteinuria and hypertension in 53% and 47.1% of patients respectively. Only one patient developed grade 3 proteinuria after 30 cycles and another one developed pulmonary embolism. No other grade 3-4 toxicities were observed. Conclusions This retrospective study showed the efficacy and the safety of BEV alone or in association with FTM in the treatment of MGs. The protocol (No: Beva-Glio/Sep 2016). |
| first_indexed | 2024-12-21T14:19:07Z |
| format | Article |
| id | doaj.art-87ddce6c1a394614965718705c910dad |
| institution | Directory Open Access Journal |
| issn | 2396-832X |
| language | English |
| last_indexed | 2024-12-21T14:19:07Z |
| publishDate | 2018-04-01 |
| publisher | BMC |
| record_format | Article |
| series | Translational Medicine Communications |
| spelling | doaj.art-87ddce6c1a394614965718705c910dad2022-12-21T19:00:50ZengBMCTranslational Medicine Communications2396-832X2018-04-01311810.1186/s41231-018-0023-2Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomasArsela Prelaj0Sara Elena Rebuzzi1Maurizio Salvati2Silvia Pecorari3Chiara Pozzi4Carmela Fusto5Carla Ferrara6Silverio Tomao7Vincenzo Bianco8Department of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeDepartment of Medical Oncology, IRCCS San Martino ISTDepartment of Neurosurgery, IRCCS NeuromedDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeDepartment of Public Health and Infectious Diseases, “Sapienza” University of RomeDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeDepartment of Radiological, Oncological and Anatomo-Pathological Sciences, “Sapienza” University of RomeAbstract Background There is no consensus therapy recommended for recurrent malignant gliomas (MGs). In 2009, Bevacizumab (BEV) was approved by the FDA as single-agent for recurrent glioblastoma (GBM). The aim of this retrospective study was to evaluate the efficacy and the safety of BEV alone or in combination with Fotemustine (FTM) in recurrent MGs. This represents an interim analysis of a larger study on BEV in MGs patients. Methods We analyzed 17 recurrent MGs patients, 12 GBM (70.6%) and 5 anaplastic gliomas (29.4%), underwent first-line therapy with Stupp regimen. BEV was administered as off-label therapy, at a dose of 10 mg/kg every 14 days, in 13 patients as third-line therapy and in 4 patients as second-line therapy associated with FTM. The assessment of MGMT methylation and IDH1 mutation was conducted. Results One complete response (5.9%), 7 partial responses (41.2%), 3 stable diseases (17.6%) and 6 progression diseases (35.3%) were assessed using RANO criteria. Median PFS (mPFS) and OS (mOS) were 5 and 8.3 months respectively, with a 6 months-PFS of 41.2%. Methylated patients and wild-type IDH1 patients showed longer mPFS and mOS without statistical significance. Six patients (35.3%) experienced long response with high number of cycles (11-40), long PFS (11-40 months) and OS (12-42 months). BEV was well-tolerated with grade 1-2 proteinuria and hypertension in 53% and 47.1% of patients respectively. Only one patient developed grade 3 proteinuria after 30 cycles and another one developed pulmonary embolism. No other grade 3-4 toxicities were observed. Conclusions This retrospective study showed the efficacy and the safety of BEV alone or in association with FTM in the treatment of MGs. The protocol (No: Beva-Glio/Sep 2016).http://link.springer.com/article/10.1186/s41231-018-0023-2BevacizumabRecurrent glioblastomaRecurrent malignant gliomaFotemustineRetrospective study |
| spellingShingle | Arsela Prelaj Sara Elena Rebuzzi Maurizio Salvati Silvia Pecorari Chiara Pozzi Carmela Fusto Carla Ferrara Silverio Tomao Vincenzo Bianco Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas Translational Medicine Communications Bevacizumab Recurrent glioblastoma Recurrent malignant glioma Fotemustine Retrospective study |
| title | Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas |
| title_full | Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas |
| title_fullStr | Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas |
| title_full_unstemmed | Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas |
| title_short | Retrospective analysis to evaluate the efficacy and the safety of Bevacizumab in the treatment of recurrent malignant gliomas |
| title_sort | retrospective analysis to evaluate the efficacy and the safety of bevacizumab in the treatment of recurrent malignant gliomas |
| topic | Bevacizumab Recurrent glioblastoma Recurrent malignant glioma Fotemustine Retrospective study |
| url | http://link.springer.com/article/10.1186/s41231-018-0023-2 |
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