Bevacizumab Plus Irinotecan in Recurrent Glioblastoma Multiforme

Vredenburgh, James J.; Desjardins, Annick; Herndon, James E.; Marcello, Jennifer; Reardon, David A.; Quinn, Jennifer A.; Rich, Jeremy; Sathornsumetee, Sith; Gururangan, Sridharan; Sampson, John H.; Wagner, Melissa; Bailey, Leighann; Bigner, Darell D.; Friedman, Allan H.

doi:10.1200/jco.2007.12.2440

Cited by 1,273 publications

(863 citation statements)

References 30 publications

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“…In the latter study, patients who had received temozolomide as a first-line therapy benefited from a dose-intensified re-exposure, too. Another phase II study evaluated the use of bevacizumab, a monoclonal antibody to vascular endothelial growth factor, in combination with irinotecan, a topoisomerase inhibitor [18,19]. This study reached a PFS-6 of 46% in patients with recurrent glioblastoma.…”

Section: Discussionmentioning

confidence: 99%

ACNU-based chemotherapy for recurrent glioma in the temozolomide era

et al. 2008

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No standard of care for patients with recurrent glioblastoma has been defined since temozolomide has become the treatment of choice for patients with newly diagnosed glioblastoma. This has renewed interest in the use of nitrosourea-based regimens for patients with progressive or recurrent disease. The most commonly used regimens are carmustine (BCNU) monotherapy or lomustine (CCNU) combined with procarbazine and vincristine (PCV). Here we report our institutional experience with nimustine (ACNU) alone (n = 14) or in combination with other agents (n = 18) in 32 patients with glioblastoma treated previously with temozolomide. There were no complete and two partial responses. The progression-free survival (PFS) rate at 6 months was 20% and the survival rate at 12 months 26%. Grade III or IV hematological toxicity was observed in 50% of all patients and led to interruption of treatment in 13% of patients. Non-hematological toxicity was moderate to severe and led to interruption of treatment in 9% of patients. Thus, in this cohort of patients pretreated with temozolomide, ACNU failed to induce a substantial stabilization of disease in recurrent glioblastoma, but caused a notable hematotoxicity. This study does not commend ACNU as a therapy of first choice for patients with recurrent glioblastomas pretreated with temozolomide. (PCV). Here we report our institutional experience with nimustine (ACNU) alone (n=14) or in combination with other agents (n=18) in 32 patients with glioblastoma treated previously with temozolomide. There were no complete and two partial responses. The progression-free survival (PFS) rate at 6 months was 20% and the survival rate at 12 months 26%. Grade III or IV hematological toxicity was observed in 50% of all patients and led to interruption of treatment in 13% of patients. Non-hematological toxicity was moderate to severe and led to interruption of treatment in 9% of patients. Thus, in this cohort of patients pretreated with temozolomide, ACNU failed to induce a substantial stabilization of disease in recurrent glioblastoma, but caused a notable hematotoxicity. This study does not commend ACNU as a therapy of first choice for patients with recurrent glioblastomas pretreated with temozolomide.

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Section: Discussionmentioning

confidence: 99%

ACNU-based chemotherapy for recurrent glioma in the temozolomide era

et al. 2008

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“…However, no direct comparisons are available and the trials evaluating bevacizumab plus temozolomide were conducted in part in highly pretreated patient populations [72][73][74]. Five phase II trials evaluated the combination of irinotecan with bevacizumab [91][92][93][94][95], two trials added a third combination partner, cetuximab [96] or carboplatin [97]. PFS-6 rates ranged between 28 and 50.3% and median OS between 6.7 and 9.7 months.…”

Section: Bevacizumab Monotherapy and Combination Regimensmentioning

confidence: 99%

Therapeutic options in recurrent glioblastoma—An update

Seystahl

Wick

Weller

2016

Critical Reviews in Oncology/Hematology

179

134

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“…A prospective phase 2 study using every-3-week dosing of bevacizumab at a dose of 15 mg/kg in 61 patients with World Health Organization grade 3 or grade 4 glioma demonstrated no obvious differences in patient outcomes compared with contemporary studies using every-2-week dosing at 10 mg/kg, 37 thus allowing for flexibility in patient scheduling without clinical detriment. Several phase 2 trials of bevacizumab-based combinations have also been reported for recurrent glioblastoma (Table 1), 27,28,32, including bevacizumab with irinotecan, irinotecan plus cetuximab, irinotecan plus carboplatin, etoposide, fotemustine, sorafenib, temozolomide, erlotinib, and temsirolimus. 27,28,32,[38][39][40][41][42][43][44][45][46][47] In addition, several retrospective studies have also been reported combining bevacizumab and irinotecan; carboplatin; carboplatin and cetuximab; carboplatin, etoposide, and ifosfamide; lomustine; carmustine; etoposide; or temozolomide.…”

Section: Early Study Of Bevacizumab In Patients With Recurrent Glioblmentioning

confidence: 99%

“…Several phase 2 trials of bevacizumab-based combinations have also been reported for recurrent glioblastoma (Table 1), 27,28,32, including bevacizumab with irinotecan, irinotecan plus cetuximab, irinotecan plus carboplatin, etoposide, fotemustine, sorafenib, temozolomide, erlotinib, and temsirolimus. 27,28,32,[38][39][40][41][42][43][44][45][46][47] In addition, several retrospective studies have also been reported combining bevacizumab and irinotecan; carboplatin; carboplatin and cetuximab; carboplatin, etoposide, and ifosfamide; lomustine; carmustine; etoposide; or temozolomide. [48][49][50][51][52][53][54][55][56][57][58] Although these small studies are not easily compared due to their size and various patient populations, the consensus to date has been that no combination significantly surpasses the outcomes of bevacizumab monotherapy for recurrent glioma.…”

Section: Early Study Of Bevacizumab In Patients With Recurrent Glioblmentioning

confidence: 99%

Bevacizumab and glioblastoma: Scientific review, newly reported updates, and ongoing controversies

Field

Jordan

Wen

et al. 2014

Cancer

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Anti-angiogenic therapy for glioblastoma has been in the spotlight for several years, as researchers and clinicians strive to find agents with meaningful efficacy against glioblastoma. Bevacizumab in particular, in the second half of the last decade, became the most significant breakthrough in anti-glioblastoma therapy since temozolomide. Optimism for bevacizumab has been somewhat challenged given recent clinical trials that have raised questions regarding its clinical effectiveness, the optimal timing of its use and the validity of endpoints, among other issues. In addition, uncertainty has recently arisen regarding the effects of bevacizumab on quality of life and neurocognitive function, two key clinical endpoints of unquestionable significance among glioblastoma patients. In this review, we highlight these controversies and other recent work related to bevacizumab for glioblastoma. Cancer 2015;121:997

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Bevacizumab Plus Irinotecan in Recurrent Glioblastoma Multiforme

Abstract: Bevacizumab and irinotecan is an effective treatment for recurrent glioblastoma multiforme and has moderate toxicity.

Cited by 1,273 publications

References 30 publications

ACNU-based chemotherapy for recurrent glioma in the temozolomide era

ACNU-based chemotherapy for recurrent glioma in the temozolomide era

Therapeutic options in recurrent glioblastoma—An update

Bevacizumab and glioblastoma: Scientific review, newly reported updates, and ongoing controversies

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