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Journal of Neuro-Oncology

, Volume 96, Issue 2, pp 259–269 | Cite as

Salvage therapy with single agent bevacizumab for recurrent glioblastoma

  • Marc C. Chamberlain
  • Sandra K. Johnston
Clinical Study - Patient Study

Abstract

A retrospective evaluation of single agent bevacizumab in adults with recurrent glioblastoma (GBM) with an objective of determining progression free survival (PFS). There is no standard therapy for recurrent GBM after failure of alkylator-based chemotherapy. A total of 50 adults, ages 36–70 years (median 64), with recurrent GBM were treated. All patients had previously been treated with surgery, concurrent radiotherapy and temozolomide, post-radiotherapy temozolomide and in 34 patients, one salvage regimen (PCV: 21, cyclophosphamide: 13). A total of 13 patients underwent repeat surgery. Patients were treated at first or second recurrence with bevacizumab, once every 2 weeks, defined as a single cycle. Neurological evaluation was performed every 2 weeks and neuroradiographic assessment following the initial 2 cycles of bevacizumab and subsequently after every 4 cycles of bevacizumab. A total of 468 cycles of bevacizumab (median 2 cycles; range 1–30) was administered. Bevacizumab-related toxicity included fatigue (16 patients; 4 grade 3), leukopenia (9; 1 grade 3), anemia (5; 0 grade 3), hypertension (7; 1 grade 3), deep vein thrombosis (4; 1 grade 3) and wound dehiscence (2; 1 grade 3). 21 patients (42%) demonstrated a partial radiographic response and 29 (58%) progressive disease following 1–2 cycles of bevacizumab. Time to tumor progression ranged from 0.5 to 15 months (median: 1.0 months). Survival ranged from 2 to 17 months (median: 8.5 months). 6-month and 12-month PFS were 42% and 22% respectively. Single agent bevacizumab demonstrated efficacy and acceptable toxicity in this cohort of adults with recurrent alkylator-refractory GBM.

Keywords

Single agent bevacizumab Radiotherapy refractory Recurrent glioblastoma Surgery refractory Temozolomide refractory 

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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  1. 1.Department of Neurology and NeurosurgeryUniversity of Washington, Fred Hutchinson Cancer Research CenterSeattleUSA
  2. 2.Department of Neurology and NeurosurgeryUniversity of Washington, Fred Hutchinson Cancer Center, Seattle Cancer Care AllianceSeattleUSA
  3. 3.Department of Neurology, Division of Neuro-OncologyUniversity of Washington, Fred Hutchinson Cancer Research Center, Seattle Cancer Care AllianceSeattleUSA

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