Addition of lomustine for bevacizumab-refractory recurrent glioblastoma

Figures & data

Table I. Patient characteristics.

		Number of patients (n = 20)	Percentage (%)	mPFS (months)
Age (years)
Median	52.5
Range	36–73
Sex
Male		14	70
Female		6	30
Chemotherapy
1st line
TMZ/RT→TMZ		18	90	7.7
TMZ 5/28		1	5	7.7
RT		1	5	2.7
2nd line
Bevacizumab monotherapy		15	75	4.3 (combined analysis for 2nd and 3rd line)
TMZ intensified		5	25	2
3rd line
Bevacizumab monotherapy		5	25
Bevacizumab + lomustine		15	75	2.6 (combined analysis for 3rd and 4th line)	Toxicity • Grade 3/4 leukopenia and neutropenia: 5 patients • Grade 3 thrombocytopenia: 4 patients • Grade 3/4 lymphopenia: 3 patients
4th line
Bevacizumab + lomustine		5	20		• Treatment with recombinant G-CSF because of prolonged neutropenia: 1 patient • Non-hematologic: headache, fatigue and nausea: 3 patients
Karnofsky performance score at initiation of bevacizumab and lomustine	100 90 80 70 60 50	0 6 8 3 2 1	0 30 40 15 10 5
Steroid use at initiation of bevacizumab and lomustine	No Yes	18 2	90 10
MGMT status	Methylated Unmethylated Not determined	2 5 13	10 25 65

Figure 1 (A) Progression-free and overall survival of 20 patients with second or third progression of glioblastoma treated with bevacizumab and lomustine upon progression on bevacizumab monotherapy (OS with 3 censored cases because of unknown time of death (n = 2) or still alive (n = 1) at the time of closure of the database). (B) Correlation between time on bevacizumab monotherapy and survival following progression (p < 0.05; Spearman's correlation).