AI-22CLINICAL OUTCOME OF BEVACIZUMAB-TREATED PATIENTS WITH RECURRENT MALIGNANT GLIOMAS

INTRODUCTION: Currently, there is no standard therapeutic regimen for recurrent gliomas. Bevacizumab is a recombinant anti-vascular endothelial growth factor (anti-VEGF) antibody. After its approval by the US Food and Drug Administration for recurrent glioblastoma, this drug has been an emerging treatment option for recurrent gliomas; however, the European Medicines Agency has rejected the use of bevacizumab for gliomas. METHODS: We retrospectively analyzed the clinical data of bevacizumab-treated recurrent glioma patients in our department. We included 25 patients (20 men, and 5 women) with recurrent malignant gliomas, aged between 18 and 63 years (median, 39 years), who had undergone bevacizumab-based treatment between February 2009 and September 2012. RESULTS: The median follow-up period was 4 months (range, 1-17 months). The median number of bevacizumab cycles that were administered was 6 (range 1-18 cycles). All of the patients showed radiological reduction of gadorinium -enhanced lesion and 20 (83.3%) patients showed improvement of Karnofsky performance score (KPS) after bevacizumab treatment. The overall response rate was 70%. The median progression-free survival (PFS) for the entire group was 3.3 months and the 6-month PFS (PFS-6m) was 20.8%. The median overall survival (OS) and the 1-year OS (OS-1y) for all patients were 6.7 months and 33.2%, respectively. Patients with primary glioblastoma (pGB) had better OS than those with secondary glioblastoma (sGB); the median OS for pGB and sGB were 7.6, and 4.1 months, respectively (P = 0.06). CONCLUSION: Anti-angiogenic therapy using bevacizumab for recurrent gliomas appears to improve patients the activity for daily living for a few months. However, this therapy did not improve patient overall survival. Further, this therapy cannot be recommended for patients with sGB from grade II and grade III gliomas.