Cargando…

Bevacizumab for Patients with Recurrent Multifocal Glioblastomas

In patients with glioblastoma, antiangiogenic therapy with bevacizumab (BEV) has been shown to improve progression-free survival (PFS), but not overall survival (OS). Especially in patients with an unusual infiltrative phenotype as seen in multifocal glioblastoma, the use of BEV therapy is still mor...

Descripción completa

Detalles Bibliográficos
Autores principales: Burger, Michael C., Breuer, Stella, Cieplik, Hans C., Harter, Patrick N., Franz, Kea, Bähr, Oliver, Steinbach, Joachim P.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713435/
https://www.ncbi.nlm.nih.gov/pubmed/29156610
http://dx.doi.org/10.3390/ijms18112469
_version_ 1783283425471365120
author Burger, Michael C.
Breuer, Stella
Cieplik, Hans C.
Harter, Patrick N.
Franz, Kea
Bähr, Oliver
Steinbach, Joachim P.
author_facet Burger, Michael C.
Breuer, Stella
Cieplik, Hans C.
Harter, Patrick N.
Franz, Kea
Bähr, Oliver
Steinbach, Joachim P.
author_sort Burger, Michael C.
collection PubMed
description In patients with glioblastoma, antiangiogenic therapy with bevacizumab (BEV) has been shown to improve progression-free survival (PFS), but not overall survival (OS). Especially in patients with an unusual infiltrative phenotype as seen in multifocal glioblastoma, the use of BEV therapy is still more controversial. Therefore, we prepared a retrospective case series with 16 patients suffering from a multifocal glioblastoma treated with BEV. We compared these patients to a matched control cohort of 16 patients suffering from glioblastoma with a single lesion treated with BEV. The objective of this study was to evaluate whether the course of disease differs in glioblastoma patients with a multifocal disease pattern compared to those with a single lesion only. Patients were treated with BEV monotherapy or BEV in combination with irinotecan or lomustine (CCNU). Response rates and PFS were similar in both groups. There was a trend for an unfavorable OS in the patient group with multifocal glioblastoma, which was expected due to the generally worse prognosis of multifocal glioblastoma. We investigated whether BEV therapy affects the invasive growth pattern as measured by the appearance of new lesions on magnetic resonance imaging (MRI). Under BEV therapy, there was a trend for a lower frequency of new lesions both in multifocal and solitary glioblastoma. Based on these results, BEV therapy at relapse appears to be justified to no lesser extent in multifocal glioblastoma than in solitary glioblastoma.
format Online
Article
Text
id pubmed-5713435
institution National Center for Biotechnology Information
language English
publishDate 2017
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-57134352017-12-07 Bevacizumab for Patients with Recurrent Multifocal Glioblastomas Burger, Michael C. Breuer, Stella Cieplik, Hans C. Harter, Patrick N. Franz, Kea Bähr, Oliver Steinbach, Joachim P. Int J Mol Sci Article In patients with glioblastoma, antiangiogenic therapy with bevacizumab (BEV) has been shown to improve progression-free survival (PFS), but not overall survival (OS). Especially in patients with an unusual infiltrative phenotype as seen in multifocal glioblastoma, the use of BEV therapy is still more controversial. Therefore, we prepared a retrospective case series with 16 patients suffering from a multifocal glioblastoma treated with BEV. We compared these patients to a matched control cohort of 16 patients suffering from glioblastoma with a single lesion treated with BEV. The objective of this study was to evaluate whether the course of disease differs in glioblastoma patients with a multifocal disease pattern compared to those with a single lesion only. Patients were treated with BEV monotherapy or BEV in combination with irinotecan or lomustine (CCNU). Response rates and PFS were similar in both groups. There was a trend for an unfavorable OS in the patient group with multifocal glioblastoma, which was expected due to the generally worse prognosis of multifocal glioblastoma. We investigated whether BEV therapy affects the invasive growth pattern as measured by the appearance of new lesions on magnetic resonance imaging (MRI). Under BEV therapy, there was a trend for a lower frequency of new lesions both in multifocal and solitary glioblastoma. Based on these results, BEV therapy at relapse appears to be justified to no lesser extent in multifocal glioblastoma than in solitary glioblastoma. MDPI 2017-11-20 /pmc/articles/PMC5713435/ /pubmed/29156610 http://dx.doi.org/10.3390/ijms18112469 Text en © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Burger, Michael C.
Breuer, Stella
Cieplik, Hans C.
Harter, Patrick N.
Franz, Kea
Bähr, Oliver
Steinbach, Joachim P.
Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title_full Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title_fullStr Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title_full_unstemmed Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title_short Bevacizumab for Patients with Recurrent Multifocal Glioblastomas
title_sort bevacizumab for patients with recurrent multifocal glioblastomas
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5713435/
https://www.ncbi.nlm.nih.gov/pubmed/29156610
http://dx.doi.org/10.3390/ijms18112469
work_keys_str_mv AT burgermichaelc bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT breuerstella bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT cieplikhansc bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT harterpatrickn bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT franzkea bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT bahroliver bevacizumabforpatientswithrecurrentmultifocalglioblastomas
AT steinbachjoachimp bevacizumabforpatientswithrecurrentmultifocalglioblastomas