Background: Bevacizumab improves outcome for most recurrent glioblastoma patients, but the duration of benefit is limited and survival after initial bevacizumab progression is poor. We evaluated bevacizumab continuation beyond initial progression among recurrent glioblastoma patients as it is a common, yet unsupported practice in some countries. Methods: We analysed outcome among all patients (n99) who received subsequent therapy after progression on one of five consecutive, single-arm, phase II clinical trials evaluating bevacizumab regimens for recurrent glioblastoma. Of note, the five trials contained similar eligibility, treatment and assessment criteria, and achieved comparable outcome. Results: The median overall survival (OS) and OS at 6 months for patients who continued bevacizumab therapy (n55) were 5.9 months (95% confidence interval (CI): 4.4, 7.6) and 49.2% (95% CI: 35.2, 61.8), compared with 4.0 months (95% CI: 2.1, 5.4) and 29.5% (95% CI: 17.0, 43.2) for patients treated with a non-bevacizumab regimen (n44; P0.014). Bevacizumab continuation was an independent predictor of improved OS (hazard ratio0.64; P0.04). Conclusion: The results of our retrospective pooled analysis suggest that bevacizumab continuation beyond initial progression modestly improves survival compared with available non-bevacizumab therapy for recurrent glioblastoma patients require evaluation in an appropriately randomised, prospective trial.
Bibliographical noteFunding Information:
We thank Wendy Gentry for her excellent secretarial support in the development of this manuscript. This work was supported by the National Institutes of Health Grants 5P50-NS-20023 and 5 R37 CA11898; National Institutes of Health Grant MO1 RR 30. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
- malignant glioma
- vascular endothelial growth factor