Service d'Oncologie Médicale, CHU Amiens, 80054, Amiens Cedex 1, France.
Service de Pharmacie, CLCC Paul Strauss, Strasbourg, France.
J Neurooncol. 2019 Sep;144(2):419-426. doi: 10.1007/s11060-019-03245-5. Epub 2019 Jul 19.
Recurrence of glioblastoma (GB) occurs in most patients after standard concomitant temozolomide-based radiochemotherapy (CTRC). Bevacizumab (BV), an anti-VEGF antibody, has an effect on progression-free survival (PFS) but not on overall survival (OS). However, a small part of the patients experience a survival, longer than expected. This retrospective study aims to characterize long responder (LR) patients treated with BV for a first or second GBM recurrence.
Medical records from patients (814) who received BV for a first or second recurrence of primary glioblastoma between September 2010 and September 2015, and initially treated by CTRC were analyzed. Patients, who had at least a stable disease according to RANO criteria at 12 months from the start of BV, were included. Patients who had, a secondary GB, or received BV in neoadjuvant or adjuvant setting were excluded.
We focused on 65 LR patients without progression 12 months after the first injection of BV (8%). Median PFS was 21.7 months [95% CI (19.3; 27.2)] and median OS was 31.1 months [95% CI (24.3; 37.5)] from the start of BV. No prognostic factor was associated with OS in multivariate analysis. Karnofsky performance status, neurological status and corticosteroid dose were stable at 12 months.
Our results highlight that among patients receiving bevacizumab in first or second recurrence, one patient out of twelve could be classified as LR. A median OS of 31.1 months from the start of BV could be expected in this subpopulation. These findings reinforce the potential benefit of the use of BV in the situation of recurrence. 256 words.
大多数接受标准替莫唑胺联合放化疗（CTRC）治疗的胶质母细胞瘤（GB）患者在复发后会出现复发。贝伐单抗（BV），一种抗 VEGF 抗体，对无进展生存期（PFS）有影响，但对总生存期（OS）没有影响。然而，一小部分患者的生存期比预期的要长。本回顾性研究旨在对接受 BV 治疗的首次或第二次 GBM 复发的长反应（LR）患者进行特征描述。
分析了 2010 年 9 月至 2015 年 9 月期间接受 BV 治疗的初次或第二次原发性胶质母细胞瘤复发的患者（814 例）的病历，这些患者最初接受 CTRC 治疗。根据 RANO 标准，从开始使用 BV 12 个月后至少有稳定疾病的患者被纳入研究。患有继发性 GB、接受新辅助或辅助治疗或接受 BV 治疗的患者被排除在外。
我们关注的是 65 名无进展 12 个月后首次注射 BV 的 LR 患者（8%）。从开始使用 BV 计算，中位 PFS 为 21.7 个月[95%CI（19.3；27.2）]，中位 OS 为 31.1 个月[95%CI（24.3；37.5）]。多变量分析中没有预后因素与 OS 相关。Karnofsky 表现状态、神经状态和皮质类固醇剂量在 12 个月时稳定。
我们的研究结果表明，在接受首次或第二次复发 BV 治疗的患者中，每 12 名患者中就有 1 名可被归类为 LR。从开始使用 BV 计算，该亚组患者的中位 OS 可达到 31.1 个月。这些发现强化了在复发情况下使用 BV 的潜在获益。256 个单词。
