434P - Rechallenge with bevacizumab (BEV) in patients (p) with glioblastoma (GBM) and previous objective response to BEV

Date 28 September 2014
Event ESMO 2014
Session Poster Display session
Topics Cytotoxic agents
Central Nervous System Malignancies
Therapy
Biological therapy
Presenter Alberto Indacochea
Citation Annals of Oncology (2014) 25 (suppl_4): iv137-iv145. 10.1093/annonc/mdu330
Authors A. Indacochea1, A. Estival2, S. Ahlal3, O. Etxaniz2, M.D.L.L. Gil4, L. Vila4, J.L. Cuadra Urtega5, C. Carrato1, C. Balana4
  • 1Medical Oncology Service, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, 08916 - Badalona/ES
  • 2Medical Oncology, Catalan Institute of Oncology ICO Badalona Hospital Germans Trias i Pujol, Medical Oncology, 08916 - Badalona/ES
  • 3Medical Oncology, Institut Català d'Oncologia-Badalona, 08916 - Badalona/ES
  • 4Medical Oncology, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, 08916 - Badalona/ES
  • 5Medical Oncology Service, Catalan Institute of Oncology, Hospital Germans Trias i Pujol, badalona/ES

Abstract

Aim

GBM is the most common primary brain tumor and is characterized by high vascularitzation and overexpression of vascular endothelial growth factor A (VEGF-A). BEV has been approved in several countries for the treatment of recurrent GBM. While the optimal duration of treatment with BEV is unknown, treatment until progression or for a maximum of 1 year has been established in phase II studies. No therapy has demonstrated efficacy after BEV.

Methods

We have retrospectively analyzed GBM p who stopped BEV after an objective response and received rechallenge with BEV at the time of recurrence.

Results

17 p were included. 7 p (41.2%) had received neoadjuvant BEV plus temozolomide (TMZ) followed by BEV/TMZ concomitant with radiotherapy as part of the GENOM 009 trial. 5 p had attained a partial response (PR) and 2 had stable disease (SD). 6 of these p received rechallenge with BEV at the time of the first recurrence and 1 at the time of the second recurrence. Response to BEV rechallenge in these 7 p: 1 complete response (CR) (14.3%); 4 PR (57.1%); 2 SD (28.6%). The remaining 10 p had received the standard EORTC regimen as first-line therapy; 6 then received second-line treatment with BEV at the first recurrence and 4 at the second recurrence. Median duration of BEV treatment was 15.8 months (m). Outcome to second-line BEV: 5 CR (50%); 5 PR (50%); progression-free survival (PFS), 24.1 m. Of these 10 p, 8 were rechallenged with BEV at the time of recurrence. Outcome to BEV rechallenge in 6 evaluable p: 4 PR (66.6%); 1 SD (16.7%); 1 progressive disease (16.7%); PFS from start of BEV rechallenge was 6.7 m. Median overall survival from the time of diagnosis is 38.66 m for all 17 p.

Conclusions

The optimal duration of treatment with BEV at recurrence is unknown. In patients with an objective response, BEV can be stopped and new responses to rechallenge with BEV can be attained. A clinical trial is warranted to examine the comparative benefit of stopping or continuing treatment with BEV in responders.

Disclosure

All authors have declared no conflicts of interest.