Tünbekici Salih, Yuksel Haydar Cagatay, Acar Caner, Sahin Gökhan, Orman Seval, Majidova Nargiz, Coskun Alper, Seyyar Mustafa, Dilek Mehmet Sıddık, Kara Mahmut, Dıslı Ahmet Kursat, Demir Teyfik, Kolkıran Nagihan, Sahbazlar Mustafa, Demırcıler Erkut, Kuş Fatih, Aytac Ali, Menekse Serkan, Yucel Hakan, Biter Sedat, Koseci Tolga, Unsal Ahmet, Ozveren Ahmet, Sevınc Alper, Goker Erdem, Gürsoy Pınar
Department of Medical Oncology, Ege University Medical Faculty, Izmir 35040, Turkey.
Department of Medical Oncology, Kartal Dr. Lütfi Kirdar City Hospital, Health Science University, Cevizli, D-100 Güney Yanyol, Cevizli Mevkii No:47, Kartal, Istanbul 34865, Turkey.
Cancers (Basel). 2024 Dec 27;17(1):46. doi: 10.3390/cancers17010046.
BACKGROUND/OBJECTIVES: In the REGOMA trial, regorafenib demonstrated an overall survival advantage over lomustine, and it has become a recommended treatment for recurrent glioblastoma in guidelines. This study aimed to evaluate the effectiveness and safety of regorafenib as a third-line treatment for patients with recurrent glioblastoma who progressed while taking bevacizumab-based therapy.
This retrospective, multicenter study in Turkey included 65 patients treated between 2021 and 2023 across 19 oncology centers. The main inclusion criteria were histologically confirmed isocitrate dehydrogenase (IDH)-wildtype glioblastoma, progression after second-line bevacizumab-based treatment, and an Eastern Cooperative Oncology Group (ECOG) performance status score of ≤2. Patients received regorafenib 160 mg once daily for the first 3 weeks of each 4-week cycle.
The median age of the patients was 53 years (18-67 years), with a median progression-free survival of 2.5 months (95% Confidence Interval: 2.23-2.75) and a median overall survival of 4.1 months (95% CI: 3.52-4.68). The median overall survival was improved in patients who received subsequent therapy after regorafenib treatment compared with those who did not ( = 0.022). Progression-free survival was longer in patients with ECOG 0-1 than in those with ECOG 2 ( = 0.042). The safety profile was consistent with that of the REGOMA trial, with no drug-related deaths observed.
Regorafenib shows good efficacy and safety as a third-line treatment for recurrent glioblastoma after bevacizumab-based therapy. This study supports the use of regorafenib and emphasizes the need for further randomized studies to validate its role and optimize treatment strategies.
背景/目的：在REGOMA试验中，瑞戈非尼显示出比洛莫司汀更具总生存优势，并且已成为指南中推荐的复发性胶质母细胞瘤治疗药物。本研究旨在评估瑞戈非尼作为接受基于贝伐单抗治疗后病情进展的复发性胶质母细胞瘤患者三线治疗的有效性和安全性。
这项在土耳其开展的回顾性多中心研究纳入了2021年至2023年间在19个肿瘤中心接受治疗的65例患者。主要纳入标准为组织学确诊的异柠檬酸脱氢酶（IDH）野生型胶质母细胞瘤、二线基于贝伐单抗治疗后病情进展以及东部肿瘤协作组（ECOG）体能状态评分≤2。患者在每4周周期的前3周每天服用一次160mg瑞戈非尼。
患者的中位年龄为53岁（18 - 67岁），中位无进展生存期为2.5个月（95%置信区间：2.23 - 2.75），中位总生存期为4.1个月（95%CI：3.52 - 4.68）。与未接受后续治疗的患者相比，接受瑞戈非尼治疗后接受后续治疗的患者中位总生存期有所改善（P = 0.022）。ECOG 0 - 1的患者无进展生存期长于ECOG 2的患者（P = 0.042）。安全性与REGOMA试验一致，未观察到与药物相关的死亡。
瑞戈非尼作为基于贝伐单抗治疗后的复发性胶质母细胞瘤三线治疗显示出良好的疗效和安全性。本研究支持使用瑞戈非尼，并强调需要进一步的随机研究来验证其作用并优化治疗策略。
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