Bevacizumab plus Radiotherapy–Temozolomide for Newly Diagnosed Glioblastoma

• Published in: The New England journal of medicine Vol. 370; no. 8; pp. 709 - 722
• Main Authors: Chinot, Olivier L, Wick, Wolfgang, Mason, Warren, Henriksson, Roger, Saran, Frank, Nishikawa, Ryo, Carpentier, Antoine F, Hoang-Xuan, Khe, Kavan, Petr, Cernea, Dana, Brandes, Alba A, Hilton, Magalie, Abrey, Lauren, Cloughesy, Timothy
• Format: Journal Article
• Language: English
• Published: Waltham, MA Massachusetts Medical Society 20.02.2014
• Subjects: Adult; Aged; Aged, 80 and over; Angiogenesis Inhibitors - adverse effects; Angiogenesis Inhibitors - therapeutic use; Antibodies, Monoclonal, Humanized - adverse effects; Antibodies, Monoclonal, Humanized - therapeutic use; Bevacizumab; Biological and medical sciences; Body weight; Brain cancer; Brain Neoplasms - drug therapy; Brain Neoplasms - mortality; Brain Neoplasms - radiotherapy; Combined Modality Therapy; Dacarbazine - adverse effects; Dacarbazine - analogs & derivatives; Dacarbazine - therapeutic use; Disease-Free Survival; Double-Blind Method; Drug therapy; Female; General aspects; Glioblastoma; Glioblastoma - drug therapy; Glioblastoma - mortality; Glioblastoma - radiotherapy; Glucocorticoids; Humans; Immunomodulators; Immunotherapy; Induction Chemotherapy; Intravenous administration; Kaplan-Meier Estimate; Male; Medical sciences; Middle Aged; Monoclonal antibodies; Neurology; NMR; Nuclear magnetic resonance; Patients; Pharmacology. Drug treatments; Quality of Life; Radiation therapy; Survival; Targeted cancer therapy; Temozolomide; Tumors of the nervous system. Phacomatoses; Vascular endothelial growth factor; Young Adult; Antineoplastic agent; Nervous system diseases; Drug combination; Glioblastoma; Monoclonal antibody; Malignant tumor; Radiotherapy; Bevacizumab; Immunomodulator; Medicine; Malignant glioma; Alkylating agent; Vascular endothelium growth factor; Treatment; Central nervous system disease; Diagnosis; Temozolomide; Antiangiogenic agent; Cancer
• ISSN: 0028-4793; 1533-4406; 1533-4406
• DOI: 10.1056/NEJMoa1308345

In patients with glioblastoma, the addition of bevacizumab to radiotherapy and temozolomide induction therapy and the use of bevacizumab maintenance therapy did not influence overall survival. Freedom from progression was slightly increased but at the cost of increased toxic effects. Tumor progression in glioblastoma, the most common primary brain cancer, 1 , 2 is associated with deterioration in neurocognitive function, 3 , 4 decreased functional independence, 5 and a progressive decrease in health-related quality of life. 6 , 7 After surgical resection, the standard of care for patients with newly diagnosed glioblastoma and a good Karnofsky performance score (≥70, on a scale of 0 to 100, with higher numbers indicating better functioning) is concurrent radiotherapy and temozolomide, followed by adjuvant temozolomide. 8 – 11 The prognosis remains poor; no further improvements in outcomes have been documented since the introduction of radiotherapy–temozolomide therapy in 2005. Glioblastomas are characterized by overexpression . . .