Clinical Study - Patient Study

Journal of Neuro-Oncology

, Volume 92, Issue 2, pp 149-155

First online:

An exploratory survival analysis of anti-angiogenic therapy for recurrent malignant glioma

  • Andrew D. NordenAffiliated withDivision of Neuro-Oncology, Department of Neurology, Brigham and Women’s HospitalCenter for Neuro-Oncology, Dana-Farber Cancer InstituteHarvard Medical School Email author 
  • , Jan DrappatzAffiliated withDivision of Neuro-Oncology, Department of Neurology, Brigham and Women’s HospitalCenter for Neuro-Oncology, Dana-Farber Cancer InstituteHarvard Medical School
  • , Alona MuzikanskyAffiliated withMassachusetts General Hospital Biostatistics Center
  • , Karly DavidAffiliated withCenter for Neuro-Oncology, Dana-Farber Cancer Institute
  • , Mary GerardAffiliated withCenter for Neuro-Oncology, Dana-Farber Cancer Institute
  • , M. Brenna McNamaraAffiliated withCenter for Neuro-Oncology, Dana-Farber Cancer Institute
  • , Phuong PhanAffiliated withCenter for Neuro-Oncology, Dana-Farber Cancer Institute
  • , Ainsley RossAffiliated withCenter for Neuro-Oncology, Dana-Farber Cancer Institute
  • , Santosh KesariAffiliated withDivision of Neuro-Oncology, Department of Neurology, Brigham and Women’s HospitalCenter for Neuro-Oncology, Dana-Farber Cancer InstituteHarvard Medical School
    • , Patrick Y. WenAffiliated withDivision of Neuro-Oncology, Department of Neurology, Brigham and Women’s HospitalCenter for Neuro-Oncology, Dana-Farber Cancer InstituteHarvard Medical School

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Abstract

Recent clinical trial results suggest that anti-angiogenic therapy may be effective against recurrent malignant glioma. Though these treatments prolong progression-free survival, the extent to which they prolong overall survival is unknown. We pooled data from 34 patients treated at a single institution on phase II clinical trials of bevacizumab and cediranib, and we compared these data to 18 patients treated on clinical trials of cytotoxic chemotherapies. In univariate and multivariate analyses, treatment group was a significant predictor of progression-free but not overall survival. Median progression-free survival was 8 vs. 22 weeks in patients treated with cytotoxic as compared to anti-angiogenic therapy (P = 0.01). Median overall survival was nearly identical in the two groups (39 vs. 37 weeks). The results of this exploratory analysis suggest that anti-angiogenic therapy may fail to prolong overall survival in patients with recurrent malignant glioma. If this conclusion proves correct, progression-free survival may be an inappropriate endpoint for phase II trials of anti-angiogenic therapies.

Keywords

Malignant glioma Anti-angiogenic therapy Progression-free survival