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JCO: Bevacizumab in combination with radiation therapy improves the prognosis of patients with recurrent glioblastoma

 Last Update: 2022-11-01
 Source: Internet
 Author: User

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J Clin Oncol: Bevacizumab plus reradiation therapy improves outcomes in patients with recurrent glioblastoma

▎Clinical questions:
Compared with bevacizumab alone, Whether bevacizumab plus reradiation improves overall survival (OS) and/or progression-free survival (PFS) in patients with recurrent glioblastoma (GBM) is unclear
.

Results from a study from J Clin Oncol suggest that bevacizumab combined with re-radiotherapy improves outcomes
in patients with recurrent GBM.

▎Research protocol:
NRG Oncology/RTOG1205 is a prospective, phase 2, randomized trial
of re-radiotherapy plus bevacizumab versus bevacizumab alone.
Stratified factors included age, resection, and Karnofsky performance status (KPS).

Radiographic evidence of tumor progression ≥ 6 months
after completion of prior chemotherapy-RT in eligible patients with relapsed GBM.
Patients were randomized 1:1 to re-irradiation, 35 Gy, divided into 10 fractions, with bevacizumab 10 mg/kg intravenously every 2 weeks, or bevacizumab alone until disease progression
.
From December 2012 to April 2016, 182 patients were randomly assigned, of which 170 were eligible
.
The median follow-up was 12.
8 months
.

▎Key findings:
(1) There was no improvement in OS with bevacizumab + RT, the hazard ratio was 0.
98; 80% CI, 0.
79-1.
23; P=0.
46; the median survival time of bevacizumab + RT was 10.
1 months, compared with 9.
7 months
for bevacizumab alone.

(2) The median PFS of bevacizumab + RT was 7.
1 months, while bevacizumab was 3.
8 months, and the hazard ratio was 0.
73; 95% CI, 0.
53-1.
0; P=0.
05
.
The 6-month PFS rate increased from 29.
1% (95% CI, 19.
1% to 39.
1%) of bevacizumab to 54.
3% (95% CI, 43.
5% to 65.
1%) of bevacizumab + RT, P = 0.
001
.

(3) The treatment is well
tolerated.
The incidence of acute grade 3 or higher treatment-related AEs is 5%, and there is no delayed advanced AE.

Most patients die of recurrent GBM
.

▎Outlook: In summary,
Re-radiation therapy has been shown to be safe and well
tolerated.
Bevacizumab + RT showed a clinically meaningful improvement in PFS, particularly at 6 months, but there was no difference
in OS.

References: [1] https://ascopubs.
org/doi/full/10.
1200/JCO.
22.
00164
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