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Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider
INTRODUCTION: Despite a large number of trials, the role of bevacizumab (BEV) in the treatment of recurrent high-grade gliomas is still controversial. Evidence regarding an effect on overall survival in this context is ultimately inconclusive. At the Department of Radiation Oncology at Erlangen, Ger...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Springer US
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316675/ https://www.ncbi.nlm.nih.gov/pubmed/32409944 http://dx.doi.org/10.1007/s11060-020-03533-5 |
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author | Hofmann, Susanne Schmidt, Manuel Alexander Weissmann, Thomas Eyüpoglu, Ilker Strnad, Annedore Semrau, Sabine Fietkau, Rainer Putz, Florian Lettmaier, Sebastian |
author_facet | Hofmann, Susanne Schmidt, Manuel Alexander Weissmann, Thomas Eyüpoglu, Ilker Strnad, Annedore Semrau, Sabine Fietkau, Rainer Putz, Florian Lettmaier, Sebastian |
author_sort | Hofmann, Susanne |
collection | PubMed |
description | INTRODUCTION: Despite a large number of trials, the role of bevacizumab (BEV) in the treatment of recurrent high-grade gliomas is still controversial. Evidence regarding an effect on overall survival in this context is ultimately inconclusive. At the Department of Radiation Oncology at Erlangen, Germany we treated a large cohort of patients with recurrent gliomas where bevacizumab use was determined exclusively by the health care provider’s approval of reimbursement. METHODS: 61 patients (between 06/2008 and 01/2014) with recurrent high-grade gliomas had reimbursement requests for BEV sent to their health insurance. 37 patients out of 61 (60.7%) had their requests approved and therefore received bevacizumab (BEV-arm) as part of their treatment. The remaining 24 (39.3%) patients received standard therapy without bevacizumab (non-BEV-arm). Survival endpoints were defined with reference to the first BEV request to the health insurance provider. RESULTS: Median overall survival (OS) for the whole cohort was 7.0 months. OS was significantly better for BEV vs. Non-BEV patients (median, 10.3 vs. 4.2 months, logrank p = 0.023). There was an increased BEV benefit in cases of higher-order recurrences (first order recurrence BEV vs. Non-BEV, 12.5 vs. 10.2 months, p = 0.578) (second or higher order of recurrence, 9.9 vs. 2.6 months, p = 0.010). On multivariate analysis for overall survival the prognostic impact of bevacizumab (HR = 0.43, p = 0.034) remained significant. CONCLUSION: Our results suggest an influence of BEV on overall survival in a heavily pretreated patient population suffering from high-grade gliomas with BEV benefit being greatest in case of second or later recurrence. |
format | Online Article Text |
id | pubmed-7316675 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Springer US |
record_format | MEDLINE/PubMed |
spelling | pubmed-73166752020-07-01 Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider Hofmann, Susanne Schmidt, Manuel Alexander Weissmann, Thomas Eyüpoglu, Ilker Strnad, Annedore Semrau, Sabine Fietkau, Rainer Putz, Florian Lettmaier, Sebastian J Neurooncol Clinical Study INTRODUCTION: Despite a large number of trials, the role of bevacizumab (BEV) in the treatment of recurrent high-grade gliomas is still controversial. Evidence regarding an effect on overall survival in this context is ultimately inconclusive. At the Department of Radiation Oncology at Erlangen, Germany we treated a large cohort of patients with recurrent gliomas where bevacizumab use was determined exclusively by the health care provider’s approval of reimbursement. METHODS: 61 patients (between 06/2008 and 01/2014) with recurrent high-grade gliomas had reimbursement requests for BEV sent to their health insurance. 37 patients out of 61 (60.7%) had their requests approved and therefore received bevacizumab (BEV-arm) as part of their treatment. The remaining 24 (39.3%) patients received standard therapy without bevacizumab (non-BEV-arm). Survival endpoints were defined with reference to the first BEV request to the health insurance provider. RESULTS: Median overall survival (OS) for the whole cohort was 7.0 months. OS was significantly better for BEV vs. Non-BEV patients (median, 10.3 vs. 4.2 months, logrank p = 0.023). There was an increased BEV benefit in cases of higher-order recurrences (first order recurrence BEV vs. Non-BEV, 12.5 vs. 10.2 months, p = 0.578) (second or higher order of recurrence, 9.9 vs. 2.6 months, p = 0.010). On multivariate analysis for overall survival the prognostic impact of bevacizumab (HR = 0.43, p = 0.034) remained significant. CONCLUSION: Our results suggest an influence of BEV on overall survival in a heavily pretreated patient population suffering from high-grade gliomas with BEV benefit being greatest in case of second or later recurrence. Springer US 2020-05-14 2020 /pmc/articles/PMC7316675/ /pubmed/32409944 http://dx.doi.org/10.1007/s11060-020-03533-5 Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. |
spellingShingle | Clinical Study Hofmann, Susanne Schmidt, Manuel Alexander Weissmann, Thomas Eyüpoglu, Ilker Strnad, Annedore Semrau, Sabine Fietkau, Rainer Putz, Florian Lettmaier, Sebastian Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title | Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title_full | Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title_fullStr | Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title_full_unstemmed | Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title_short | Evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
title_sort | evidence for improved survival with bevacizumab treatment in recurrent high-grade gliomas: a retrospective study with (“pseudo-randomized”) treatment allocation by the health insurance provider |
topic | Clinical Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7316675/ https://www.ncbi.nlm.nih.gov/pubmed/32409944 http://dx.doi.org/10.1007/s11060-020-03533-5 |
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