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在复发性胶质母细胞瘤患者中,贝伐单抗与卡铂联合使用相对于单独使用卡铂的附加价值。

The added value of bevacizumab concomitantly administered with carboplatin versus carboplatin alone in patients with recurrent glioblastomas.

作者信息

Kaloshi Gentian, Diamandi Pavllo, Cakani Bujar, Brace Gramoz, Rroji Arben, Petrela Mentor

机构信息

Department of Neurosurgery, University Hospital Center "Mother Theresa", Tirana - Albania.

出版信息

Tumori. 2015 Jan-Feb;101(1):41-5. doi: 10.5301/tj.5000210. Epub 2015 Feb 11.

Abstract

AIMS AND BACKGROUND

Carboplatin (CBDCA) and bevacizumab (BEV) are active in glioblastoma (GBM) with different profiles of toxicity. To date, no study has compared the value of the addition of BEV to historical or traditional cytotoxic chemotherapy. We sought to determine the relative value of BEV in combination with CBDCA versus CBDCA alone in patients with recurrent GBM.

METHODS AND STUDY DESIGN

Eligible patients with progressive GBM following surgery, radiotherapy and temozolomide received CBDCA either alone (group 1, n = 25) or in combination with BEV (group 2, n = 23) at 5 mg/kg once every 3 weeks between June 2010 and December 2013. Baseline characteristics and outcomes after treatment were recorded. The primary end points of this retrospective analysis were progression-free survival (PFS) and objective response rate. Secondary end points included safety and overall survival (OS).

RESULTS

Forty-eight patients were enrolled. The median number of cycles was 4 in group 1 and 6 in group 2. No toxicities or intracerebral bleeding were observed. The objective response rate was higher in group 2 than group 1, 66% vs 24% (p = 0.003). The estimated median PFS and OS were 3.1 vs 6.7 months (p<0.0001) and 6.1 vs 8.6 months (p = 0.09) in group 1 vs group 2, respectively.

CONCLUSIONS

The combination of BEV and CBDCA is associated with improved response rates and survival compared with CBDCA alone. These results highlight the value of BEV in recurrent GBM. However, the clinical benefit of this interesting approach needs validation in a larger patient cohort.

摘要

目的与背景

卡铂(CBDCA)和贝伐单抗(BEV)对胶质母细胞瘤(GBM)有效,但毒性特征不同。迄今为止,尚无研究比较在传统细胞毒性化疗基础上加用BEV的价值。我们试图确定复发性GBM患者中,BEV联合CBDCA与单用CBDCA相比的相对价值。

方法与研究设计

2010年6月至2013年12月期间,符合条件的患者在手术、放疗和替莫唑胺治疗后出现GBM进展,接受CBDCA单药治疗(第1组,n = 25)或与BEV联合治疗(第2组,n = 23),每3周一次,剂量为5mg/kg。记录基线特征和治疗后的结果。这项回顾性分析的主要终点是无进展生存期(PFS)和客观缓解率。次要终点包括安全性和总生存期(OS)。

结果

共纳入48例患者。第1组的中位周期数为4个,第2组为6个。未观察到毒性反应或脑内出血。第2组的客观缓解率高于第1组,分别为66%和24%(p = 0.003)。第1组和第2组的估计中位PFS分别为3.1个月和6.7个月(p<0.0001),中位OS分别为6.1个月和8.6个月(p = 0.09)。

结论

与单用CBDCA相比,BEV联合CBDCA可提高缓解率和生存率。这些结果凸显了BEV在复发性GBM中的价值。然而,这种有意义的治疗方法的临床益处需要在更大的患者队列中进行验证。

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