Concurrent Stereotactic Radiosurgery and Bevacizumab in Recurrent Malignant Gliomas: A Prospective Trial

Cabrera, Alvin R.; Cuneo, Kyle C.; Desjardins, Annick; Sampson, John H.; McSherry, Frances; Herndon, James E.; Peters, Katherine B.; Allen, Karen; Hoang, Jenny K.; Chang, Zheng; Craciunescu, Oana; Vredenburgh, James J.; Friedman, Henry S.; Kirkpatrick, John P.

doi:10.1016/j.ijrobp.2013.04.029

Cited by 90 publications

(63 citation statements)

References 18 publications

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“…A prospective study evaluating stereotactic radiosurgery plus bevacizumab (n=8 patients with anaplastic glioma, n=7 with glioblastoma) reported a median PFS of3.9 and median OS 14.4 months. Toxicity included one grade 3 and two grade 2 CNS toxicities [43].…”

Section: Repeat Radiotherapymentioning

confidence: 99%

Therapeutic options in recurrent glioblastoma—An update

Seystahl

Wick

Weller

2016

Critical Reviews in Oncology/Hematology

179

134

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Section: Repeat Radiotherapymentioning

confidence: 99%

Therapeutic options in recurrent glioblastoma—An update

Seystahl

Wick

Weller

2016

Critical Reviews in Oncology/Hematology

179

134

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“…However, many BM patients are eligible to SRS and it could be assumed that the good safety profile of BEV administration with a large radiation volume may also be expected in the context of its combination with smaller volume as in SRS. This assumption seems confirmed by some recent data of SRS combined with BEV in patients with recurrent malignant gliomas, confirming the feasibility of this approach with a good safety profile (5)(6)(7)(8). Clinical evaluation of BEV combined with SRS through a prospective trial is urgently needed for patients with BM.…”

mentioning

confidence: 58%

Sense and sensibility to early combine bevacizumab to radiation treatment of brain metastasis: reply to Lou and Sperduto

Lévy

Dugué

Clarisse³

2016

Ann. Transl. Med.

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“…They documented a 50% RR in the GBM population and a median OS of 12.5 months (102,106). Another prospective study, in 15 patients with recurrent malignant gliomas, reported one grade 3 and no grade 4-5 toxicities, while QoL and neurocognition were well maintained (88). Median OS from SRS was 14.4 months.…”

Section: Combination Treatmentmentioning

confidence: 97%

“…Regarding toxicity, it was mild in one study, while neurologic toxicity was reported in two other studies (8-13%) (89,100,101). Several studies have investigated adding bevacizumab to SRS (72,88,(102)(103)(104)(105). A prospective trial at MemorialSloan Kettering Cancer Center, investigating the safety of SRS (30 Gy in 5 fractions) with bevacizumab, reported no radionecrosis among 25 recurrent malignant glioma patients, but three patients discontinued treatment because of bevacizumab grade 3 related toxicity.…”

Section: Combination Treatmentmentioning

confidence: 98%

“…The studies were nearly all retrospective, however, lacking randomized control groups and with inherent selection bias limiting conclusions. Several of the early studies involving single-fraction SRS reported high rates of radiation necrosis requiring reoperation (20-40%) (86,(88)(89)(90). Compared to SRS, the use of HFSRT may help to mitigate the risk of adverse radiation events.…”

Section: Stereotactic Radiosurgery and Hypofractionated Stereotactic mentioning

confidence: 99%

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Current Standards of Care in Glioblastoma Therapy

et al. 2017

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Glioblastoma (GBM) is the most common primary malignant brain tumor in adults. Regardless of ideal multidisciplinary treatment, including maximal surgical resection, followed by radiotherapy plus concomitant and maintenance temozolomide (TMZ), almost all patients experience tumor progression with nearly universal mortality and a median survival of less than 15 months. The addition of bevacizumab to standard treatment with TMZ revealed no increase in overall survival (OS) but improved progression-free survival (PFS). In newly diagnosed GBM, methylation of the O6-methylguanine-DNA methyltransferase (MGMT) promoter has been shown to predict response to alkylating agents, as well asgnosis. Therefore, MGMT promoter status may have a crucial role in the choice of single modality treatment in fragile elderly population. No standard of care is established in recurrent or progressive GBM. Treatment alternatives may include supportive care, surgery, re-irradiation, systemic therapies, and combined modality therapy. Despite numerous clinical trials, the identification of effective therapies is complex because of the lack of appropriate control arms, selection bias, small sample sizes, and disease heterogeneity. Tumor-treating fields plus TMZ represent a major advance in the field of GBM therapy, and should be Standards of Care in Glioblastoma Therapy 198 considered for patients with newly diagnosed GBM with no contraindications. As a disease with such a poor prognosis, treatment of GBM should go beyond improving survival and aim at preserving and even improving the quality of life of both the patient and the caregiver.

show abstract

Concurrent Stereotactic Radiosurgery and Bevacizumab in Recurrent Malignant Gliomas: A Prospective Trial

Cited by 90 publications

References 18 publications

Therapeutic options in recurrent glioblastoma—An update

Therapeutic options in recurrent glioblastoma—An update

Sense and sensibility to early combine bevacizumab to radiation treatment of brain metastasis: reply to Lou and Sperduto

Current Standards of Care in Glioblastoma Therapy

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