432P - Patterns and efficacy of bevacizumab use across treatment lines in glioblastoma

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Anti-Cancer Agents & Biologic Therapy
Central Nervous System Malignancies
Presenter Maryyam Azam
Citation Annals of Oncology (2014) 25 (suppl_4): iv137-iv145. 10.1093/annonc/mdu330
Authors M.B. Azam1, Y.S. Rho2, A. Mamo2, S. Sahebjam3, T. Muanza4, M. Guiot5, J. Al-Shami6, R. Sharma7, P. Kavan8
  • 1Experimental Medicine, McGill University, H3A0G4 - Montreal/CA
  • 2Medical Oncology, Jewish General Hospital McGill University, H3T1E2 - Montreal/CA
  • 3Medical Oncology, Moffitt Cancer Centre, 33612 - Tampa/US
  • 4Radiation Oncology, Jewish General Hospital McGill University, H3T1E2 - Montreal/CA
  • 5Pathology, Montreal Neurological Institute, H3A2B4 - Montreal/CA
  • 6Clinical Research, McGill University, H3A0G4 - Montreal/CA
  • 7Clinical Research, Royal Victoria Hospital, H3A1A1 - Montreal/CA
  • 8Mcgill Adolescent And Young Adult Oncology Program, Jewish General Hospital, McGill University, H3T 1E2 - Montreal/CA

Abstract

Aim

Use of bevacizumab in the management of glioblastoma multiforme (GMB) remains controversial. Currently in Canada, it is approved for recurrent GBM treatment. We describe the use of bevacizumab and analyses the efficacy across treatment lines in GBM.

Methods

Patients (pts) diagnosed GBM (primary or secondary) from 2008-2014 and treated with bevacizumab were identified at McGill University Hospitals; demographics, diagnosis, and treatment pattern were collected via chart review. Primary endpoints were median progression-free survival (PFS) and overall survival (OS) estimated via Kaplan-Meier method. Secondary endpoint was toxicity. Grading of adverse events (AEs) were in accordance to CTCAE 4.0 criteria.

Results

64 pts were identified and their files were analyzed (40 males; median age at diagnosis 54 years, range 26-83). Majority had KPS score ≥70 (n = 56, 87.5%). 49 (76.6%) pts had primary and 15 (23.4%) had secondary GBM. Available MGMT testing was performed in 24 pts (methylated n = 10, 15.6%; unmethylated n = 14, 21.9%). 30 (46.9%) received bevacizumab in 1st line and 34 (53.1%) 2nd line and beyond (2L+). The median duration of bevacizumab in 1st line 36.6 weeks and 2L+ 14.21 weeks (overall 24.4 weeks; range <1-232.7). 59 (93.7%) received combination therapy. Progression pattern showed: 22 local progression (34.4%), 25 diffuse pattern (39%), 4 multifocal spread (6.3%), 3 distant progression (4.8%), and 4 multi-pattern progression (6.3%). Median OS for those who received bevacizumab in 1st line was 13 months, 2L+ 5.8 months, and 19.1 months overall. Median PFS in 1st line was 9.700 (95% CI: 6.200 - 15.000), 2L+ 2.900 (95% CI: 2.100 to 4.700), and 5.800 (95% CI: 3.300 - 9.900) overall. Total 57 (89.1%) grade 3-4 AEs occurred: thrombocytopenia (n = 8; 12.5%), hypertension (n = 7; 10.9%), deep vein thrombosis (n = 6; 9.4%), fatigue (n = 4; 6.2%), seizures (n = 4; 6.2%), neutropenia (n = 3;4.7%), leukopenia (n = 2;3.1%), pulmonary embolism (n = 2; 3.1%), proteinuria (n = 2; 3.1%), stroke (n = 2; 3.1%), myocardial infarction (n = 2; 3.1%), and brain hemorrhage (n = 2; 3.1%).

Conclusions

Our results show bevacizumab treatment may be more efficient after a recurrence than when used in the beginning of treatment and are in line with reported registration trials data.

Disclosure

All authors have declared no conflicts of interest.