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Late-line treatment with bevacizumab alone or in combination with chemotherapy in recurrent high-grade gliomas

  • Original Article - Tumor - Glioma
  • Published:
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Abstract

Purpose

Bevacizumab’s use in recurrent high-grade glioma is controversial. This study evaluates outcomes in recurrent high-grade glioma patients receiving bevacizumab alone or combined with chemotherapy as a late-line treatment.

Methods

We retrospectively analyzed patients treated with bevacizumab alone or combined with chemotherapy for high-grade gliomas who showed tumor progression after multiple treatment attempts. Overall survival (OS) and progression-free survival (PFS) were analyzed with Kaplan–Meier curves. Predictors of PFS according to prognostic variables were assessed with regression analysis.

Results

Between 2010 and 2022, 31 consecutive patients received bevacizumab alone or combined with chemotherapy as a late-line treatment for recurrent high-grade gliomas. Of these patients, 14 (45.2%) were responders according to RANO criteria, and 17 (54.8%) showed progressive or stable disease. OS at 3, 6, and 12 months was 80.3%, 62.1%, and 43.5. PFS was 48.4%, 34.3%, and 21.8%, respectively. In the multivariate survival analysis, the only factor independently associated with PFS was smaller 2D tumor size in post-contrast T1-weighted MRI at bevacizumab initiation (p = 0.02). Median time-to-progression was 3 months (95%CI: 1–4) in the unmethylated MGMT promoter group and 6 (95%CI: 1–11) in the methylated MGMT promoter group. This difference was not statistically significant (p = 0.37).

Conclusions

Bevacizumab alone or in combination with chemotherapy could be beneficial as a late-line therapy in a subset of patients with recurrent high-grade glioma. Small 2D tumor size in post-contrast T1 weighted MRI at bevacizumab initiation was independently associated with prolonged time to progression.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

TMZ:

Temozolomide

VEGF:

Vascular endothelial growth factor

PFS:

Progression-free survival

OS:

Overall survival

MRI:

Magnetic resonance imaging

11C-MET-PET:

Positron emission tomography imaging with 11C methionine

KPS:

Karnofsky Performance Scale

RANO:

Response Assessment in Neuro-Oncology

IQR:

Interquartile ranges

IDH:

Isocitrate dehydrogenases

EGFR:

Epidermal growth factor receptor

MGMT:

O6 methylguanine-DNA methyl-transferase

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Author information

Authors and Affiliations

  1. Department of Neurosurgery, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium

    Mehdi Yahia-Cherif, Olivier De Witte & Florence Lefranc

  2. Department of Oncology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium

    Sylvie Luce

  3. Department of Radiology, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium

    Niloufar Sadeghi-Meibodi

  4. Department of Nuclear Medicine, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070, Brussels, Belgium

    Gil Leurquin-Sterk

Authors
  1. Mehdi Yahia-Cherif
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  2. Sylvie Luce
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  3. Olivier De Witte
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  4. Niloufar Sadeghi-Meibodi
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  5. Gil Leurquin-Sterk
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  6. Florence Lefranc
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Contributions

All authors contributed to the study’s conception and design. Material preparation, data collection, and analysis were performed by Mehdi Yahia-Cherif. Mehdi Yahia-Cherif wrote the first draft, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Florence Lefranc.

Ethics declarations

Ethics approval

The study obtained institutional ethics committee approval by the Ethics committee ULB-Erasme, number: 2022/204.

Consent to participate

This retrospective study was approved by the institutional ethics committee approval, and patients’ consents were waived.

Consent for publication

This retrospective study was approved by the institutional ethics committee approval, and patients’ consents were waived.

Conflict of interest

The authors declare no competing interests.

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Yahia-Cherif, M., Luce, S., De Witte, O. et al. Late-line treatment with bevacizumab alone or in combination with chemotherapy in recurrent high-grade gliomas. Acta Neurochir 165, 693–699 (2023). https://doi.org/10.1007/s00701-023-05524-7

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  • DOI: https://doi.org/10.1007/s00701-023-05524-7

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