Glioblastoma survival in the United States improved after Food and Drug Administration approval of bevacizumab: A population‐based analysis

• Published in: Cancer Vol. 119; no. 19; pp. 3489 - 3495
• Main Authors: Johnson, Derek R., Leeper, Heather E., Uhm, Joon H.
• Format: Journal Article
• Language: English
• Published: Hoboken, NJ Wiley-Blackwell 01.10.2013
• Subjects: Adolescent; Adult; Age groups; Aged; Angiogenesis Inhibitors - administration & dosage; Antibodies, Monoclonal, Humanized - administration & dosage; Bevacizumab; Biological and medical sciences; Brain Neoplasms - drug therapy; Brain Neoplasms - mortality; Female; glioblastoma; Glioblastoma - drug therapy; Glioblastoma - mortality; Humans; Male; Medical sciences; Middle Aged; Multiple tumors. Solid tumors. Tumors in childhood (general aspects); Neurology; prognosis; SEER Program; survival; Survival Analysis; Treatment Outcome; Tumors; Tumors of the nervous system. Phacomatoses; United States - epidemiology; United States Food and Drug Administration; Young Adult; United States; North America; America; USA; Antineoplastic agent; Human; Nervous system diseases; Program; Prognosis; Glioblastoma; Monoclonal antibody; Malignant tumor; SEER program; Survival; Bevacizumab; Immunomodulator; Malignant glioma; Cancerology; Vascular endothelium growth factor; Central nervous system disease; Antiangiogenic agent; Food and Drug Administration; Cancer; bevacizumab; glioblastoma; prognosis; survival
• ISSN: 0008-543X; 1097-0142
• DOI: 10.1002/cncr.28259

BACKGROUND Bevacizumab received US Food and Drug Administration approval for use in recurrent glioblastoma based on promising radiographic response data, but without clear evidence that it prolongs survival. A population‐based analysis was conducted to determine whether bevacizumab approval was associated with improved glioblastoma survival in the United States. METHODS Surveillance, Epidemiology, and End Results (SEER) Program data were used to compare survival of glioblastoma patients who died in 2006, 2008 (both prior to approval of bevacizumab), and 2010 (after approval of bevacizumab). RESULTS The SEER database contained 1715 patients with glioblastoma who died in 2006, 1924 who died in 2008, and 1968 who died in 2010 who met study inclusion criteria. Median survival was 8 months for those who died in 2006, 7 months in 2008, and 9 months in 2010. The difference in survival between 2008 (pre‐bevacizumab) and 2010 (post‐bevacizumab) was highly significant. This difference is unlikely to be due to improvements in supportive care in this short interval, because there was no significant difference (P = .4440) between patients who died in 2006 versus those who died in 2008. Between 2008 and 2010, a statistically significant improvement in survival was seen in all age groups except those patients aged 18 to 39 years. CONCLUSIONS Patients who died of glioblastoma in 2010 had lived with disease significantly longer than patients who died in 2008. The most likely explanation for this change is the approval and use of bevacizumab for progressive glioblastoma, indicating that at a population level, treatment strategies involving bevacizumab prolong survival. Cancer 2013;119:3489–3495.. © 2013 American Cancer Society. Analysis of Surveillance, Epidemiology, and End Results (SEER) Program data shows that glioblastoma patients who died in 2010 had lived with disease longer than patients who died in 2008. This improvement is hypothesized to be related to the availability of bevacizumab at the time of tumor progression for patients who died in 2010.