Al's Comment:

Bevacizumab is an FDA approved treatment for Glioblastoma, which inhibits VEGF (Vascular endothelial growth factor).  By itself, for glioblastomas,  it did not increase overall survival, but it did make people feel better for a longer time - with an increased progression free survival.  It is thought that combining it with other drugs is more rational than using it by itself if the purpose is to extend life.  (It can be used by itself as a super steroid to get rid of swelling). This study reviews the medical literature and reports on which combinations did the best.  Unfortunately, the best combination they found was Bevacizumab plus Rindopepimut. I say unfortunate because Rindopepimut is no longer available.   It is a therapeutic vaccine against EGFRvIII.  It did very well in early trials, but in a large randomized trial, it did not do better than the control group - which was an immune enhancer that is also part of Rindopepimut.  Both groups did better than expected by historical controls, but the way the  trial was designed  resulted in failure and they no longer make the drug.

IF the Promising Pathway Act ever passes, there is a possibility of going back and reviving some of these treatments that "failed" even though they had good results in some patients and did what they were supposed to do. In this case, Rindopepimut was supposed to inhibit EGFRvIII and it did. It helped a little but not enough to get approved by itself. It's real strength would have been as part of a cocktail approach as mentioned in this current study where it says adding Bevacizumab to Rindopepimut resulted in the best results.  I think we need 4 or 5 drug combinations to hit the home run, but to get that far we need access to the components!


Posted on: 01/04/2022

Efficacy and safety of bevacizumab combined with other therapeutic regimens for treatment of recurrent glioblastoma: A network meta-analysis

 


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