The Addition of Bevacizumab to Standard Radiation Therapy and Temozolomide Followed by Bevacizumab, Temozolomide, and Irinotecan for Newly Diagnosed Glioblastoma
- 15 June 2011
- journal article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 17 (12), 4119-4124
- https://doi.org/10.1158/1078-0432.ccr-11-0120
Abstract
Purpose: To determine if the addition of bevacizumab to radiation therapy and temozolomide, followed by bevacizumab, temozolomide, and irinotecan, for newly diagnosed glioblastoma patients is safe and effective. Experimental Design: A total of 75 patients with newly diagnosed glioblastoma were enrolled in the phase II trial that investigated the addition of bevacizumab to standard radiation therapy and daily temozolomide followed by the addition of bevacizumab and irinotecan to adjuvant temozolomide. The bevacizumab was given at 10 mg/kg every 14 days beginning a minimum of 4 weeks postcraniotomy. Two weeks after radiation therapy, the patients began 6 to 12 cycles of 5-day temozolomide with bevacizumab and irinotecan every 14 days. The primary endpoint was the proportion of patients alive 16 months after informed consent. Results: The therapy had moderate toxicity. Three patients, one of whom had a grade 2 central nervous system hemorrhage, came off study during radiation therapy. Seventy patients started the postradiation therapy, and 16 (23%) terminated this adjuvant therapy early because of toxicity. The median overall survival was 21.2 months (95% CI: 17.2–25.4), and 65% of the patients were alive at 16 months (95% CI: 53.4–74.9). The median progression-free survival was 14.2 months (95% CI: 12–16). Conclusion: The addition of bevacizumab to standard radiation therapy and temozolomide, followed by bevacizumab, irinotecan, and temozolomide, for the treatment of newly diagnosed glioblastoma has moderate toxicity and may improve efficacy compared with historical controls. The results from phase III trials are required before the role of bevacizumab for newly diagnosed glioblastoma is established. Clin Cancer Res; 17(12); 4119–24. ©2011 AACR.Keywords
This publication has 23 references indexed in Scilit:
- Tumor invasion after treatment of glioblastoma with bevacizumab: radiographic and pathologic correlation in humans and miceNeuro-Oncology, 2010
- DNA topoisomerase I inhibition by camptothecin induces escape of RNA polymerase II from promoter-proximal pause site, antisense transcription and histone acetylation at the human HIF-1α gene locusNucleic Acids Research, 2009
- Talampanel With Standard Radiation and Temozolomide in Patients With Newly Diagnosed Glioblastoma: A Multicenter Phase II TrialJournal of Clinical Oncology, 2009
- Angiogenesis in brain tumoursNature Reviews Neuroscience, 2007
- Phase II Trial of Bevacizumab and Irinotecan in Recurrent Malignant GliomaClinical Cancer Research, 2007
- Radiotherapy plus Concomitant and Adjuvant Temozolomide for GlioblastomaNew England Journal of Medicine, 2005
- Antiangiogenic Therapy of Cerebral Melanoma Metastases Results in Sustained Tumor Progression via Vessel Co-OptionClinical Cancer Research, 2004
- Intracavitary VEGF, bFGF, IL-8, IL-12 levels in primary and recurrent malignant gliomaJournal of Neuro-Oncology, 2003
- Vessel Cooption, Regression, and Growth in Tumors Mediated by Angiopoietins and VEGFScience, 1999
- Recursive Partitioning Analysis of Prognostic Factors in Three Radiation Therapy Oncology Group Malignant Glioma TrialsJNCI Journal of the National Cancer Institute, 1993