Al's Comment:
This shows that a small % of patients go on to become long term survivors using Avastin. The big trials for Avastin "failed" just like some of the immunotherapy trials "failed" because they look at the median patient to determine how well the treatments do. (Avastin showed an increase in the median progression free survival but not median overall survival). These treatments do not help the majority of patients, but they do help a minority of patients. The statistics we use does not recognize the importance of the tail of the long term survivors.
Even though each one alone only gives a small % of long term survivors, there is hope that the right combination of these could help the majority of patients become long term survivors.
Posted on: 07/29/2019
J Neurooncol. 2019 Jul 19. doi: 10.1007/s11060-019-03245-5. [Epub ahead of print]
Long-term survival in patients with recurrent glioblastoma treated with bevacizumab: a multicentric retrospective study.
Morisse MC1, Etienne-Selloum N2,3, Bello-Roufai D4, Blonski M5, Taillandier L5, Lorgis V6, Noël G7, Ahle G8, Durán-Peña A9, Boone M1, Chauffert B10.
Author information:
1. Service d'Oncologie Médicale, CHU Amiens, 80054, Amiens Cedex 1, France.
2. Service de Pharmacie, CLCC Paul Strauss, Strasbourg, France.
3. UMR 7021 CNRS, Laboratoire de Bioimagerie Et Pathologies, Faculté de Pharmacie, Université de Strasbourg, Illkirch, France.
4. Département de Recherche Clinique, Institut Curie Site Saint Cloud, Saint Cloud, France.
5. Service de Neuro-Oncologie, CHU Nancy, Nancy, France.
6. Service d'Oncologie Médicale, CLCC Georges-François Leclerc, Dijon, France.
7. Service de Radiothérapie, CLCC Paul Strauss, Strasbourg, France.
8. Service de Neurologie, Hôpitaux Civils de Colmar, Colmar, France.
9. Sorbonne Université, APHP, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, Service de Neurologie 2-Mazarin, Paris, France.
10. Service d'Oncologie Médicale, CHU Amiens, 80054, Amiens Cedex 1, France. Chauffert.Bruno@chu-amiens.fr.
Abstract
PURPOSE:
Recurrence of glioblastoma (GB) occurs in most patients after standard concomitant temozolomide-based radiochemotherapy (CTRC). Bevacizumab (BV), an anti-VEGF antibody, has an effect on progression-free survival (PFS) but not on overall survival (OS). However, a small part of the patients experience a survival, longer than expected. This retrospective study aims to characterize long responder (LR) patients treated with BV for a first or second GBM recurrence.
METHODS:
Medical records from patients (814) who received BV for a first or second recurrence of primary glioblastoma between September 2010 and September 2015, and initially treated by CTRC were analyzed. Patients, who had at least a stable disease according to RANO criteria at 12 months from the start of BV, were included. Patients who had, a secondary GB, or received BV in neoadjuvant or adjuvant setting were excluded.
RESULTS:
We focused on 65 LR patients without progression 12 months after the first injection of BV (8%). Median PFS was 21.7 months [95% CI (19.3; 27.2)] and median OS was 31.1 months [95% CI (24.3; 37.5)] from the start of BV. No prognostic factor was associated with OS in multivariate analysis. Karnofsky performance status, neurological status and corticosteroid dose were stable at 12 months.
CONCLUSIONS:
Our results highlight that among patients receiving bevacizumab in first or second recurrence, one patient out of twelve could be classified as LR. A median OS of 31.1 months from the start of BV could be expected in this subpopulation. These findings reinforce the potential benefit of the use of BV in the situation of recurrence. 256 words.
PMID: 31325146
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