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Rechallenge with bevacizumab in patients with glioblastoma progressing off therapy

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Abstract

Rechallenge with temozolomide has been shown to be a valid option in selected patients with progressive glioblastoma. Herein, we assessed the efficacy of rechallenge with bevacizumab in glioblastoma patients progressing off therapy. We retrospectively identified and analyzed the characteristics of patients with glioblastoma rechallenged with a bevacizumab-based chemotherapy regimen after having received bevacizumab as first-line treatment in association with temozolomide radiochemotherapy or at recurrence in association with temozolomide, CCNU or irinotecan. Twenty-five patients were identified. In all included patients, the first bevacizumab treatment resulted in an objective response and was discontinued for reasons other than disease progression (adverse event n = 9, physician or patient decision n = 16). Median duration of first bevacizumab treatment was 6 months (range: 2–58 months). None of the patients presented a rebound effect after bevacizumab discontinuation. The median interval between discontinuation of first bevacizumab treatment and bevacizumab rechallenge was 8.9 months (range: 2–58 months). At this time, bevacizumab was given in association with lomustine (n = 17), temozolomide (n = 6), irinotecan (n = 1), or alone (n = 1). Bevacizumab rechallenge resulted in an objective response in 15 patients (60%). Median progression-free survival was 6.7 months and overall survival was 9.6 months after bevacizumab rechallenge. Timing of first bevacizumab treatment (as first-line treatment or at recurrence) was not associated with the duration of response after treatment rechallenge. In the present series, patients who responded to bevacizumab and in whom this treatment was discontinued in the absence of tumor progression seemed to benefit from rechallenge with a bevacizumab-based chemotherapy regimen.

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Authors and Affiliations

  1. Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, 59 Bvd Pinel, 69394, Lyon Cedex, France

    Charlotte Bronnimann, Cristina Izquierdo, Stéphanie Cartalat, Laure Thomas, Bastien Joubert, Jérôme Honnorat & François Ducray

  2. Université Claude Bernard Lyon 1, Lyon, France

    Bastien Joubert, Marc Barritault, David Meyronet, Jérôme Honnorat & François Ducray

  3. Department of Cancer Cell Plasticity, Cancer Research Centre of Lyon, INSERM U1052, CNRS UMR5286, Lyon, France

    Marc Barritault, David Meyronet & François Ducray

  4. Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuropathologie, 59 Bvd Pinel, 69394, Lyon Cedex, France

    Marc Barritault, David Meyronet & François Ducray

  5. Hospices Civils de Lyon, Groupe Hospitalier Est, Service de Neuro-Oncologie, 59 Bvd Pinel, 69394, Lyon Cedex, France

    Laura Delpech

  6. Institut NeuroMyoGene, INSERM 1217/CNRS 5310, Université de Lyon, Lyon, France

    Jérôme Honnorat

Authors
  1. Charlotte Bronnimann
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  2. Cristina Izquierdo
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  3. Stéphanie Cartalat
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  4. Laure Thomas
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  5. Bastien Joubert
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  6. Laura Delpech
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  7. Marc Barritault
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  8. David Meyronet
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  9. Jérôme Honnorat
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  10. François Ducray
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Corresponding author

Correspondence to François Ducray.

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Bronnimann, C., Izquierdo, C., Cartalat, S. et al. Rechallenge with bevacizumab in patients with glioblastoma progressing off therapy. J Neurooncol 138, 141–145 (2018). https://doi.org/10.1007/s11060-018-2780-1

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  • DOI: https://doi.org/10.1007/s11060-018-2780-1

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