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Journal of Neuro-Oncology

, Volume 129, Issue 1, pp 93–100 | Cite as

Prognostic factors in recurrent glioblastoma patients treated with bevacizumab

  • Christina Schaub
  • Julia Tichy
  • Niklas Schäfer
  • Kea Franz
  • Frederic Mack
  • Michel Mittelbronn
  • Sied Kebir
  • Anna-Luisa Thiepold
  • Andreas Waha
  • Natalie Filmann
  • Mohammed Banat
  • Rolf Fimmers
  • Joachim P. Steinbach
  • Ulrich Herrlinger
  • Johannes Rieger
  • Martin Glas
  • Oliver Bähr
Clinical Study

Abstract

The value of bevacizumab (BEV) in recurrent glioblastoma is unclear. Imaging parameters and progression-free survival (PFS) are problematic endpoints. Few data exist on clinical factors influencing overall survival (OS) in unselected patients with recurrent glioblastoma exposed to BEV. We retrospectively analyzed 174 patients with recurrent glioblastoma treated with BEV at two German brain tumor centers. We evaluated general patient characteristics, MGMT status, pretreatment, concomitant oncologic treatment and overall survival. Karnofsky performance score, number of prior chemotherapies, number of prior recurrences and combined treatment with irinotecan (IRI) were significantly associated with OS in univariate analysis. We did not find differences in OS related to sex, age, histology, MGMT status, prior surgical treatment or number of prior radiotherapies. Combined treatment with IRI and higher KPS both remained significantly associated with prolonged survival in multivariate analysis, but patients receiving IRI co-treatment had less advanced disease. Grouping into clinically relevant categories revealed an OS of 16.9 months from start of BEV in patients with first recurrence and KPS ≥ 80 % (n = 25). In contrast, in patients with second recurrence and KPS < 80 %, OS was 3.6 months (n = 27). Our observational data support an early use of BEV in patients with good performance status. The benefit of co-treatment with IRI in our cohort seems to be the result of biased patient recruitment.

Keywords

Recurrent glioblastoma Bevacizumab Irinotecan Survival Karnofsky performance score 

Notes

Acknowledgments

The Dr. Senckenberg Institute of Neurooncology is supported by the Dr. Senckenberg Foundation and the Hertie Foundation. J.P.S. is “Hertie Professor of Neurooncology”.

Compliance with ethical standards

Conflict of Interest

Joachim P. Steinbach has served as a consultant for Roche the European distributer of Bevacizumab. Ulrich Herrlinger has served as a consultant for Roche. He has also received scientific grants and speakers honoraria from Roche. Johannes Rieger has served as a consultant for Roche. Martin Glas has served as a consultant for Roche and has received speakers honoraria form Roche. Oliver Bähr has served as a consultant for Roche and has received travel grants from Roche. Niklas Schäfer received honoraria from Roche. All other authors declare that they have no conflict of interest.

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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Christina Schaub
    • 1
  • Julia Tichy
    • 2
  • Niklas Schäfer
    • 1
    • 3
  • Kea Franz
    • 4
  • Frederic Mack
    • 1
  • Michel Mittelbronn
    • 5
  • Sied Kebir
    • 1
    • 3
  • Anna-Luisa Thiepold
    • 2
  • Andreas Waha
    • 6
  • Natalie Filmann
    • 7
  • Mohammed Banat
    • 8
  • Rolf Fimmers
    • 9
  • Joachim P. Steinbach
    • 2
  • Ulrich Herrlinger
    • 1
  • Johannes Rieger
    • 2
  • Martin Glas
    • 1
    • 3
    • 10
  • Oliver Bähr
    • 2
  1. 1.Division of Clinical Neurooncology, Department of NeurologyUniversity of Bonn Medical CenterBonnGermany
  2. 2.Dr. Senckenberg Institute of NeurooncologyUniversity Hospital Frankfurt, Goethe UniversityFrankfurtGermany
  3. 3.Stem Cell Pathologies Group, Institute of Reconstructive NeurobiologyUniversity of Bonn Medical CenterBonnGermany
  4. 4.Department of NeurosurgeryGoethe University HospitalFrankfurtGermany
  5. 5.Institute of Neurology (Edinger-Institute)Goethe University HospitalFrankfurtGermany
  6. 6.Institute of NeuropathologyUniversity of Bonn Medical CenterBonnGermany
  7. 7.Institute of Biostatistics and Mathematical ModelingGoethe University Hospital FrankfurtFrankfurtGermany
  8. 8.Department of NeurosurgeryUniversity of Bonn Medical CenterBonnGermany
  9. 9.Institute of Medical Biometry, Informatics and EpidemiologyUniversity of Bonn Medical CenterBonnGermany
  10. 10.Clinical Cooperation Unit NeurooncologyMediClin Robert Janker KlinikBonnGermany

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