At-11 * Final Results From the Randomized Phase Ii Trial Avareg (Ml25739) With Bevacizumab (Bev) or Fotemustine (Ftm) in Recurrent GBM

Brandes, Alba Ariela; Finocchiaro, Gaetano; Zagonel, Vittorina; Reni, Michele; Fabi, Alessandra; Caserta, Claudia; Clavarezza, Matteo; Maiello, Evaristo; Cartenì, Giacomo; Rosti, Giovanni; Eoli, Marica; Lombardi, Giuseppe; Monteforte, Marta; Agati, R.; Eusebi, Vincenzo; Gallì, Anna; Doria, Simona; Franceschi, Enrico

doi:10.1093/neuonc/nou237.11

Cited by 4 publications

(4 citation statements)

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“…Chinot et al 10 and Gilbert et al 31 conducted phase III clinical trials with a placebo control group, the results showed that PFS increased by 40%–71% compared with the control group. Special related research on OS, Brandes et al 32 and Wick et al 33 also found that BEV failed to improve OS of patients with glioma in a randomised study analysing BEV. From the above research, BEV can improve the PFS of glioma patients within 18 months, but the PFS of patients may be reduced after 30 months.…”

Section: Discussionmentioning

confidence: 97%

Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis

et al. 2021

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ObjectiveTo assess the efficacy and safety of bevacizumab (BEV) in patients with glioma.DesignSystematic review and meta-analysis.ParticipantsAdults aged 18 years and above, whose histology was confirmed to be malignant glioma.Primary and secondary outcome measuresThe main indicators included progression-free survival (PFS) rate and overall survival (OS) rate, and the secondary indicators were adverse reactions.ResultsA total of 11 clinical centre trials were included in this study for meta-analysis, including 2392 patients. The results of the meta-analysis showed that the median PFS rate of the BEV group was significantly higher than that of the non-BEV group (p<0.00001). When comparing PFS between two groups, we found that the PFS in the BEV group was higher than that in the non-BEV group at 6 months (OR 3.31, 95% CI 2.74 to 4.00, p<0.00001), 12 months (OR 2.05, 95% CI 1.70 to 2.49, p<0.00001) and 18 months (OR 1.31, 95% CI 1.02 to 1.69, p=0.03). But at 24 months (OR 0.83, 95% CI 0.50 to 1.37, p=0.47), there was no significant difference between the two groups. At 30 months (OR 0.62, 95% CI 0.39 to 0.97, p=0.04), the PFS of the BEV group was lower than that of the non-BEV group. Moreover, The results showed that BEV had no significant effect on improving OS, but the adverse reaction in BEV group was significantly higher than that in non-BEV group.ConclusionThe evidence suggests that BEV can significantly prolong the PFS of patients with glioma within 18 months and shorten the PFS of patients after 30 months. This limitation may be related to the subgroup of patients, the change of recurrence mode, the optimal dose of drug, the increase of hypoxia, the enhancement of invasiveness and so on. Therefore, it is necessary to carry out more samples and higher quality large-scale research in the future.

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Section: Discussionmentioning

confidence: 97%

Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis

et al. 2021

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“…These responses are transient, however, and other recent prospective comparisons of Bevacizumab with other chemotherapeutic regimens have shown no significant increase in overall survival (OS) [232425]. …”

Section: Body Textmentioning

confidence: 99%

“…Multiple studies using Bevacizumab in combination with chemotherapy [ 15 16 17 18 19 20 21 22 ], as well as two phase II trials using Bevacizumab alone [ 5 6 ], have demonstrated both radiographic responses and increased PFS in patients with recurrent glioma, relative to historical data in patients who received chemotherapy alone. These responses are transient, however, and other recent prospective comparisons of Bevacizumab with other chemotherapeutic regimens have shown no significant increase in overall survival (OS) [ 23 24 25 ].…”

Section: Body Textmentioning

confidence: 99%

Bevacizumab in Recurrent Glioma: Patterns of Treatment Failure and Implications

Saad

Clarke

et al. 2017

Brain Tumor Res Treat

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Glioblastoma, the most common primary malignant brain tumor in adults, is highly aggressive and associated with a poor prognosis. Bevacizumab, a monoclonal antibody against the vascular endothelial growth factor receptor, has increasingly been used in the treatment of recurrent glioblastoma. It has achieved excellent rates of radiographic response, but most patients will progress after only a few months. Upon recurrence, tumors may not enhance, secondary to vascular normalization. We describe four patterns of radiographic progression commonly associated with Bevacizumab failure: 1) Distant enhancing tumor, 2) Local tumor progression without enhancement, 3) Diffuse gliomatosis-like infiltration, and 4) Local or multifocal progression, with enhancement. Some have noted an increased incidence of distant or diffuse disease upon recurrence, suggestive of a transition to a more aggressive phenotype, but a review of the literature suggests there is no conclusive evidence that Bevacizumab treatment is associated with an increased rate of distant or diffuse recurrence.

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“…Brandes et al [17] presented the results of the Italian randomized Phase II study AVAreg (n = 91) comparing in recurrent GBM patients BEV versus fotemustine, a nitrosourea chemotherapy. Similar to that of the above-mentioned BELOB trial, there was equivalent 6-month OS outcomes, the primary study end point (62% BEV vs 73% fotemustine).…”

Section: Salvage Trialsmentioning

confidence: 99%

A selected review of abstracts from the 19th annual meeting of the Society for Neuro-Oncology

Chamberlain¹

2015

CNS Oncol.

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The Society for Neuro-Oncology is the largest neuro-oncology meeting in the USA that meets annually and provides a multiday venue presenting new brain cancer clinical trials and basic research data primarily pertaining to gliomas. The Society for Neuro-Oncology 2014 meeting comprising one education day, 3 days of presentation, over 200 oral presentations and 600 abstracts provides a comprehensive overview of neuro-oncology that includes metastatic diseases of the CNS as well as primary brain tumors. This summary attempts to highlight select abstracts presented at this year's meeting in a short review that provides a synopsis of a large and multifaceted meeting.

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At-11 * Final Results From the Randomized Phase Ii Trial Avareg (Ml25739) With Bevacizumab (Bev) or Fotemustine (Ftm) in Recurrent GBM

Cited by 4 publications

References 0 publications

Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis

Efficacy and safety of bevacizumab in the treatment of adult gliomas: a systematic review and meta-analysis

Bevacizumab in Recurrent Glioma: Patterns of Treatment Failure and Implications

A selected review of abstracts from the 19th annual meeting of the Society for Neuro-Oncology

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