PMID- 19822869
OWN - NLM
STAT- MEDLINE
DCOM- 20091104
LR  - 20220409
IS  - 1526-632X (Electronic)
IS  - 0028-3878 (Print)
IS  - 0028-3878 (Linking)
VI  - 73
IP  - 15
DP  - 2009 Oct 13
TI  - Patterns of relapse and prognosis after bevacizumab failure in recurrent 
      glioblastoma.
PG  - 1200-6
LID - 10.1212/WNL.0b013e3181bc0184 [doi]
AB  - BACKGROUND: Bevacizumab has recently been approved by the US Food and Drug 
      Administration for recurrent glioblastoma (GBM). However, patterns of relapse, 
      prognosis, and outcome of further therapy after bevacizumab failure have not been 
      studied systematically. METHODS: We identified patients at Memorial 
      Sloan-Kettering Cancer Center with recurrent GBM who discontinued bevacizumab 
      because of progressive disease. RESULTS: There were 37 patients (26 men with a 
      median age of 54 years). The most common therapies administered concurrently with 
      bevacizumab were irinotecan (43%) and hypofractionated reirradiation (38%). The 
      median overall survival (OS) after progressive disease on bevacizumab was 4.5 
      months; 34 patients died. At the time bevacizumab was discontinued for tumor 
      progression, 17 patients (46%) had an increase in the size of enhancement at the 
      initial site of disease (local recurrence), 6 (16%) had a new enhancing lesion 
      outside of the initial site of disease (multifocal), and 13 (35%) had progression 
      of predominantly nonenhancing tumor. Factors associated with shorter OS after 
      discontinuing bevacizumab were lower performance status and nonenhancing pattern 
      of recurrence. Additional salvage chemotherapy after bevacizumab failure was 
      given to 19 patients. The median progression-free survival (PFS) among these 19 
      patients was 2 months, the median OS was 5.2 months, and the 6-month PFS rate was 
      0%. CONCLUSIONS: Contrast enhanced MRI does not adequately assess disease status 
      during bevacizumab therapy for recurrent glioblastoma (GBM). A nonenhancing tumor 
      pattern of progression is common after treatment with bevacizumab for GBM and is 
      correlated with worse survival. Treatments after bevacizumab failure provide only 
      transient tumor control.
FAU - Iwamoto, F M
AU  - Iwamoto FM
AD  - Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 
      10065, USA.
FAU - Abrey, L E
AU  - Abrey LE
FAU - Beal, K
AU  - Beal K
FAU - Gutin, P H
AU  - Gutin PH
FAU - Rosenblum, M K
AU  - Rosenblum MK
FAU - Reuter, V E
AU  - Reuter VE
FAU - DeAngelis, L M
AU  - DeAngelis LM
FAU - Lassman, A B
AU  - Lassman AB
LA  - eng
GR  - 5 R01 CA076423-09/CA/NCI NIH HHS/United States
GR  - UO1 CA-105663-01/CA/NCI NIH HHS/United States
GR  - 5 R01 CA121327-02/CA/NCI NIH HHS/United States
GR  - CA92629-06/CA/NCI NIH HHS/United States
GR  - 2 P30 CA008748-27/CA/NCI NIH HHS/United States
GR  - 1N01 CM-62206/CM/NCI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - Neurology
JT  - Neurology
JID - 0401060
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Antibodies, Monoclonal)
RN  - 0 (Antibodies, Monoclonal, Humanized)
RN  - 2S9ZZM9Q9V (Bevacizumab)
SB  - IM
CIN - Neurology. 2010 Apr 13;74(15):1239-41. PMID: 20385899
MH  - Adult
MH  - Aged
MH  - Angiogenesis Inhibitors/*therapeutic use
MH  - Antibodies, Monoclonal/*therapeutic use
MH  - Antibodies, Monoclonal, Humanized
MH  - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
MH  - Bevacizumab
MH  - Brain Neoplasms/*drug therapy/mortality/therapy
MH  - Disease-Free Survival
MH  - Drug Resistance, Neoplasm/*drug effects
MH  - Female
MH  - Glioblastoma/*drug therapy/mortality/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Metastasis
MH  - Neoplasm Recurrence, Local
MH  - Prognosis
MH  - Retrospective Studies
MH  - Salvage Therapy
MH  - Treatment Failure
PMC - PMC2839807
EDAT- 2009/10/14 06:00
MHDA- 2009/11/05 06:00
PMCR- 2010/10/13
CRDT- 2009/10/14 06:00
PHST- 2009/10/14 06:00 [entrez]
PHST- 2009/10/14 06:00 [pubmed]
PHST- 2009/11/05 06:00 [medline]
PHST- 2010/10/13 00:00 [pmc-release]
AID - 73/15/1200 [pii]
AID - znl03909001200 [pii]
AID - 10.1212/WNL.0b013e3181bc0184 [doi]
PST - ppublish
SO  - Neurology. 2009 Oct 13;73(15):1200-6. doi: 10.1212/WNL.0b013e3181bc0184.