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Abstract
Background. Patients with recurrent high-grade glioma (HGG) have a poor prognosis and there is no defined standard of care. High levels of vascular endothelial growth factor (VEGF) expressed in HGG make the anti-VEGF monoclonal antibody bevacizumab (BEV) of particular interest. Patients and methods. In an ongoing registry data were collected from patients who have received BEV for the treatment of recurrent HGG. The primary objective was the identification of any clinical benefit as assessed by change in Karnofsky Performance Score (KPS), decreased steroid use and duration of treatment. Results. Two hundred and twenty-five patients with HGG were included (176 glioblastoma; 49 anaplastic glioma; median age 52 years). KPS improved in 10% of patients and remained stable in 68%. Steroids were stopped in 37.6% of patients. Median duration of treatment was 5.5 months; 19.1% of patients were treated for more than 12 months. Median overall survival from beginning of BEV treatment was 8.5 months. At the time of analysis, 169 patients (75.1%) had died and 56 patients (24.9%) were alive. Only 21 patients (9.3%) discontinued treatment due to toxicity. Conclusions. Our data reveal valuable palliation with preservation of KPS and an option for steroid withdrawal in patients treated with BEV, supporting the role of this therapy in late-stage disease.
Acknowledgements
We sincerely thank Barbara Hofstetter for her invaluable support during the project and critical review of the manuscript. We also thank Laura McDonagh for her editorial support. This work was supported in part by an unrestricted grant from Roche (USZ-NEURO-15122008). SH receives research support and honoraria for advisory board participation and lectures from Roche and Schering Plough. AO is a member of a Roche advisory board. PW is a member of a Schering-Plough advisory board. WW receives lecture honoraria and consultancy honoraria from Roche. MW receives research support and honoraria for advisory board participation and lectures from Merck Serono, Roche and Schering Plough.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.