Department of Neuro-Oncology, University and City of Health and Science Hospital of Turin, Turin, Italy.
Expert Rev Neurother. 2014 Jan;14(1):1-3. doi: 10.1586/14737175.2014.873277.
Trials on recurrent glioblastoma have shown that bevacizumab alone is able to increase response rate on MRI, median and 6-month progression-free survival (PFS), and modestly overall survival, allowing an improvement of neurological function and a reduction of steroids. Any drug combination was not superior over bevacizumab alone. A synergistic effect of CCNU has been suggested when added to bevacizumab (BELOB trial), but excluded when added to cediranib (REGAL trial). Phase III trials on bevacizumab in newly diagnosed glioblastoma have shown an improvement of PFS of 3-4 months, but failed to prolong overall survival. The AVAglio trial has reported an improvement of quality of life, while the RTOG 0825 did not, and suggested a negative impact on neurocognitive functions. The GLARIUS trial, focusing on newly diagnosed glioblastoma without MGMT methylation, suggested an advantage for bevacizumab plus irinotecan. The Phase III CENTRIC trial has excluded any role for cilengitide in addiction to standard treatment in newly diagnosed glioblastoma.
复发性脑胶质瘤的临床试验表明，贝伐单抗单药治疗能够提高 MRI 反应率、中位无进展生存期（PFS）和 6 个月 PFS，以及适度的总生存期，从而改善神经功能并减少类固醇的使用。任何药物联合治疗均不比贝伐单抗单药治疗更有效。当贝伐单抗联合洛莫司汀（BELOB 试验）时，可能存在协同作用，但当联合西地尼布（REGAL 试验）时则不存在。贝伐单抗治疗新诊断脑胶质瘤的 III 期临床试验显示 PFS 可延长 3-4 个月，但未能延长总生存期。AVAglio 试验报告称，生活质量得到改善，而 RTOG 0825 试验则没有，且提示对神经认知功能有负面影响。GLARIUS 试验专注于未经 MGMT 甲基化的新诊断脑胶质瘤，提示贝伐单抗联合伊立替康具有优势。CENTRIC 期 III 试验排除了西仑吉肽在新诊断脑胶质瘤标准治疗基础上的附加作用。
