The addition of bevacizumab to standard radiation therapy and temozolomide followed by bevacizumab, temozolomide, and irinotecan for newly diagnosed glioblastoma Full Text
Clinical Cancer Research, 07/03/2011  Clinical Article

Vredenburgh JJ et al. – The addition of bevacizumab to standard radiation therapy and temozolomide, followed by bevacizumab, irinotecan, and temozolomide, for the treatment of newly diagnosed glioblastoma has moderate toxicity and may improve efficacy compared with historical controls. The results from phase III trials are required before the role of bevacizumab for newly diagnosed glioblastoma is established.

• Total of 75 patients with newly diagnosed glioblastoma enrolled in phase II trial that investigated the addition of bevacizumab to standard radiation therapy and daily temozolomide followed by addition of bevacizumab and irinotecan to adjuvant temozolomide
• Bbevacizumab given at 10 mg/kg every 14 days beginning minimum of 4 weeks postcraniotomy
• 2 weeks after radiation therapy, patients began 6 to 12 cycles of 5-day temozolomide with bevacizumab and irinotecan every 14 days
• Primary endpoint was proportion of patients alive 16 months after informed consent

• Therapy had moderate toxicity
• 3 patients, 1 of whom had a grade 2 central nervous system hemorrhage, came off study during radiation therapy
• 70 patients started postradiation therapy, and 16 (23%) terminated this adjuvant therapy early because of toxicity
• Median OS 21.2 months (95% CI: 17.2–25.4), and 65% of patients were alive at 16 months (95% CI: 53.4–74.9)
• Median PFS 14.2 months (95% CI: 12–16)