Abstract | INTRODUCTION: Despite a large number of trials, the role of bevacizumab (BEV) in the treatment of recurrent high-grade gliomas is still controversial. Evidence regarding an effect on overall survival in this context is ultimately inconclusive. At the Department of Radiation Oncology at Erlangen, Germany we treated a large cohort of patients with recurrent gliomas where bevacizumab use was determined exclusively by the health care provider's approval of reimbursement. METHODS: 61 patients (between 06/2008 and 01/2014) with recurrent high-grade gliomas had reimbursement requests for BEV sent to their health insurance. 37 patients out of 61 (60.7%) had their requests approved and therefore received bevacizumab (BEV-arm) as part of their treatment. The remaining 24 (39.3%) patients received standard therapy without bevacizumab (non-BEV-arm). Survival endpoints were defined with reference to the first BEV request to the health insurance provider. RESULTS: Median overall survival (OS) for the whole cohort was 7.0 months. OS was significantly better for BEV vs. Non-BEV patients (median, 10.3 vs. 4.2 months, logrank p = 0.023). There was an increased BEV benefit in cases of higher-order recurrences (first order recurrence BEV vs. Non-BEV, 12.5 vs. 10.2 months, p = 0.578) (second or higher order of recurrence, 9.9 vs. 2.6 months, p = 0.010). On multivariate analysis for overall survival the prognostic impact of bevacizumab (HR = 0.43, p = 0.034) remained significant. CONCLUSION: Our results suggest an influence of BEV on overall survival in a heavily pretreated patient population suffering from high-grade gliomas with BEV benefit being greatest in case of second or later recurrence.
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Authors | Susanne Hofmann, Manuel Alexander Schmidt, Thomas Weissmann, Ilker Eyüpoglu, Annedore Strnad, Sabine Semrau, Rainer Fietkau, Florian Putz, Sebastian Lettmaier |
Journal | Journal of neuro-oncology
(J Neurooncol)
Vol. 148
Issue 2
Pg. 373-379
(Jun 2020)
ISSN: 1573-7373 [Electronic] United States |
PMID | 32409944
(Publication Type: Journal Article)
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Chemical References |
- Antineoplastic Agents, Immunological
- Bevacizumab
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Topics |
- Adult
- Aged
- Antineoplastic Agents, Immunological
(therapeutic use)
- Bevacizumab
(therapeutic use)
- Brain Neoplasms
(drug therapy)
- Female
- Glioma
(drug therapy)
- Humans
- Insurance, Health
- Male
- Middle Aged
- Neoplasm Recurrence, Local
(drug therapy)
- Retrospective Studies
- Treatment Outcome
- Young Adult
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