Department of Neurology and Neurological Surgery, Fred Hutchinson Cancer Research Center, University of Washington, Seattle Cancer Care Alliance, Seattle, WA, USA.
Expert Rev Neurother. 2012 Aug;12(8):929-36. doi: 10.1586/ern.12.84.
One hundred patients, aged 36-84 years (median 62 years) with recurrent glioblastoma (GBM), were treated previously with surgery, concurrent radiotherapy and temozolomide and postradiotherapy temozolomide followed by single-agent bevacizumab (BEV) at either first (60 patients) or second recurrence (40 patients). Patients were then treated following progression on BEV only with BEV and carboplatin (75 patients), cyclophosphamide (15 patients) or BCNU (ten patients; BEV+). Three hundred and sixteen treatment cycles (median: 2; range: 1-9) were administered of BEV+. There were 74 grade 3 adverse events in 29 patients (29%) and 20 grade 4 adverse events in ten patients (10%). Following 2 months of BEV+, 60 patients (60%) demonstrated progressive disease and discontinued therapy. Forty patients (40%) had neuroradiographic stable disease. Survival ranged from 1 to 12 months (median: 4 months). Median and 6-month progression free survival was 2.5 months and 5%, respectively. BEV plus a cytotoxic chemotherapy demonstrated limited efficacy in BEV-refractory GBM and emphasizes an unmet need in neuro-oncology in adults with BEV-refractory GBM.
100 例年龄 36-84 岁（中位年龄 62 岁）的复发性胶质母细胞瘤（GBM）患者，既往接受过手术、同步放化疗和替莫唑胺治疗，放疗后再接受替莫唑胺单药治疗，然后使用贝伐珠单抗（BEV）治疗。其中首次复发 60 例，再次复发 40 例。在 BEV 治疗进展后，患者仅接受 BEV 和卡铂（75 例）、环磷酰胺（15 例）或洛莫司汀（BCNU，10 例；BEV+）治疗。共给予患者 316 个 BEV+治疗周期（中位数：2；范围：1-9）。29 例患者（29%）出现 74 次 3 级不良事件，10 例患者（10%）出现 20 次 4 级不良事件。在接受 BEV+治疗 2 个月后，60 例患者（60%）出现疾病进展，停止治疗。40 例患者（40%）出现神经影像学稳定疾病。生存时间为 1-12 个月（中位生存时间：4 个月）。中位和 6 个月无进展生存率分别为 2.5 个月和 5%。BEV 联合细胞毒性化疗在 BEV 耐药性 GBM 中疗效有限，强调了成人 BEV 耐药性 GBM 神经肿瘤学中存在未满足的需求。
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