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Bevacizumab Use for Recurrent High-Grade Glioma at McGill University Hospital

Published online by Cambridge University Press:  23 September 2014

Solmaz Sahebjam ,
Evgenia Garoufalis ,
Marie-Christine Guiot ,
Thierry Muanza ,
Rolando Del Maestro ,
Kevin Petrecca ,
Rajesh Sharma  and
Petr Kavan
Solmaz Sahebjam
Affiliation:
Drug Development Program, Princess Margaret Hospital, Toronto, Ontario
Evgenia Garoufalis
Affiliation:
Department of Oncology, McGill University, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec Canada
Marie-Christine Guiot
Affiliation:
Department of Pathology, McGill University, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec Canada
Thierry Muanza
Affiliation:
Division of Radiation Oncology, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec Canada
Rolando Del Maestro
Affiliation:
Department of Oncology and Segal Cancer Centre, McGill University, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec; Canada
Kevin Petrecca
Affiliation:
Department of Oncology and Segal Cancer Centre, McGill University, Department of Neurology and Neurosurgery, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec; Canada
Rajesh Sharma
Affiliation:
Department of Oncology, McGill University, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec Canada
Petr Kavan*
Affiliation:
Department of Oncology, McGill University, Montreal Neurological Institute and Hospital, McGill University, Montreal, Quebec Canada
*
McGill University, Royal Victoria Hospital, Department of Oncology, 687 Pine avenue West, Montreal, Quebec, H3a 1a1, Canada. Email: [email protected].
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Abstract

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Background:

Bevacizumab, a humanized recombinant anti-vascular endothelial growth factor antibody, was approved in Canada in 2010 for the treatment of high-grade glioma. We report the effectiveness and safety of bevacizumab in the treatment of patients with recurrent high-grade gliomas at a single institution.

Methods:

Twenty-seven consecutive patients with high-grade glioma (anaplastic glioma and glioblastoma) at first or subsequent relapse were treated with bevacizumab alone or in combination with chemotherapy. The primary endpoint was progression-free survival (PFS) and secondary endpoints were objective response rate, six month PFS, overall survival (OS), and safety profile.

Results:

The clinical benefit rate (complete and partial responses plus stable disease) was 59%. Median PFS was 4.3 (95% CI, 3.0-10.9) months, with a six month PFS rate of 43%. Median OS after current relapse was 8.9 (95% CI, 5.8-not reached) months. Ten episodes of grade 3/4 adverse events were observed in nine patients, including fatigue (n = 3), thrombocytopenia (n = 4), and myelotoxicity, febrile neutropenia, and pulmonary embolism (each n = 1).

Conclusions:

We consider the efficacy and safety profile of bevacizumab is comparable to other cohorts of patients treated for recurrent high-grade glioma at other international institutions.

Résumé:

Résumé: Contexte:

Le bevacizumab, un anticorps recombinant humanisé dirigé contre le facteur de croissance endothélial vasculaire, a été approuvé au Canada en 2010 pour le traitement du gliome de haut grade de malignité. Nous rapportons l'efficacité et la sécurité du bevacizumab dans le traitement de patients présentant une récidive de gliomes de haut grade de malignité dans notre institution.

Méthode:

Vingt-sept patients consécutifs atteints de gliomes de haut grade de malignité (gliomes anaplasiques et glioblastomes) ont été traités par le bevacizumab seul ou en combinaison à la chimiothérapie à la première récidive ou au moment de récidives subséquentes. le critère d'évaluation primaire était la survie sans progression (SSP) et les critères d'évaluation secondaires étaient le taux de réponse objective, une SSP de 6 mois, la survie globale (SG), et le profil de sécurité.

Résultats:

Le taux de bénéfice clinique (réponse complète et partielle avec maladie stable) était de 59%. la SSP médiane était de 4,3 mois (IC à 95%: 3,0 à 10,9) avec un taux de SSP de 6 mois de 43%. la SG médiane après la récidive en cours était de 8,9 mois (IC à 95% de 5,8 à non atteinte). Dix épisodes d'incidents thérapeutiques de grade ¾ ont été observés chez 9 patients, dont de la fatigue (n = 3), une thrombocytopénie (n = 4) et une myélotoxicité, une neutropénie fébrile et une embolie pulmonaire (n = 1 chacun).

Conclusions:

Nous considérons que le profil d'efficacité et de sécurité du bevacizumab que nous avons observé est comparable à celui d'autres cohortes de patients traités pour une récidive d'un gliome de haut grade de malignité dans d'autres institutions internationales.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 40 , Issue 2 , March 2013 , pp. 241 - 246
Copyright
Copyright © The Canadian Journal of Neurological 2013

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