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Ann Oncol. 2010 Jan 11. [Epub ahead of print]
Bevacizumab and dose-intense temozolomide in recurrent high-grade glioma.
Verhoeff JJ, Lavini C, van Linde ME, Stalpers LJ, Majoie CB, Reijneveld JC, van
Furth WR, Richel DJ.
BACKGROUND: Angiogenesis inhibition is a rational treatment strategy for
high-grade glioma (HGG). Combined antiangiogenic therapy and chemotherapy could
be beneficial, taking advantage of different mechanisms of antitumour activity
of both therapies. We carried out a phase I-II clinical trial with the
combination of bevacizumab and continuous dose-intense temozolomide (TMZ) for
patients with a recurrent HGG after first- or second-line treatment. PATIENTS
AND METHODS: Twenty-three HGG patients were treated with bevacizumab (10 mg/kg
i.v. every 3 weeks) and TMZ (daily 50 mg/m(2)), until clinical or radiological
progression. Conventional and dynamic magnetic resonance imaging (MRI) were
carried out on days -4, 3 and 21 and until clinical or radiological progression.
RESULTS: Overall response rate (20%), 6-month progression-free survival (PFS6)
(17.4%), median progression-free survival (13.9 weeks) and median overall
survival (OS) (17.1 weeks) were considerably lower compared with most other
studies with bevacizumab-containing regimens. The dynamic MRI parameters
contrast transfer coefficient and relative cerebral blood volume decreased
rapidly during the early phases of treatment, reflecting changes in
vascularisation and vessel permeability but not in tumour activity. In addition,
>50% of patients showed oedema reduction and a reduced shift on T1 images.
CONCLUSION: Treatment with bevacizumab and TMZ is feasible and well tolerated
but did not improve PFS6 and median OS.
PMID: 20064829 [PubMed - as supplied by publisher]