Can bevacizumab prolong survival for glioblastoma patients through multiple lines
of therapy?
Author(s): Brandes AA(1), Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B,
Carpentier AF.
Affiliation(s): Author information:
(1)Department of Medical Oncology, Azienda USL Bellaria-Maggiore Hospital, Via
Altura 3, Bologna, 40139, Italy.
Publication date & source: 2014, Future Oncol. , 10(7):1137-45
Glioblastoma has a poor prognosis accompanied by debilitating neurological
symptoms and impaired quality of life. Effective treatment strategies are needed,
beyond the current standard of care (SOC), to improve outcomes. Glioblastomas are
highly vascularized with elevated levels of VEGF, representing an appropriate
target for selective therapies. The role of the anti-VEGF agent bevacizumab in
newly diagnosed and recurrent glioblastoma is not fully clear at this time.
Although bevacizumab has demonstrated improvements in progression-free survival
in newly diagnosed and recurrent glioblastoma, there remain challenges in
assessing disease progression after antiangiogenic treatment. The bevacizumab
mechanism of action suggests a rationale for continuing bevacizumab treatment
through multiple lines of therapy, strengthened by longer progression-free and
overall survival observed with bevacizumab continuation beyond progression in a
Phase III study in metastatic colorectal cancer and in pooled analyses of Phase
II trials in glioblastoma. A novel study (randomized, double-blind, Phase IIIb;
TAMIGA [MO28347]) aims to evaluate whether continuing bevacizumab plus lomustine
(as second-line therapy) and SOC (third line and beyond) improves survival
compared with placebo plus lomustine and then placebo plus SOC in patients with
glioblastoma who progressed after first-line bevacizumab plus SOC.
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