Second-Line Chemotherapy in Recurrent Glioblastoma: A 2-Cohort Study

Oncol Res Treat. 2015;38(7-8):348-54. doi: 10.1159/000431236. Epub 2015 Jun 18.

Abstract

Background: Glioblastoma (GB) is the most common malignant primary central nervous system tumor in adults. Standard-of-care therapy includes surgical resection, radiotherapy and temozolomide, but nearly all patients experience disease progression. The purpose of this study was to describe 2 cohorts of patients with recurrent GB submitted to second-line treatment with procarbazine/lomustine/vincristine (PCV) or bevacizumab/irinotecan (BI).

Material and methods: Retrospective analysis of GB patients treated in our center with PCV or BI, after progression with temozolomide, between 2004 and 2012.

Results: Among 60 patients, 41 were treated with BI and 19 with PCV. According to the Macdonald criteria, the overall response rate in the BI group was 66% (n = 27) while it was 11% (n = 2) in the PCV group. The median progression-free survival was 5 and 3 months in the BI and PCV group, respectively. The median overall survival (OS) since second-line chemotherapy was 9 months in the BI group and 5 months in the PCV group. The latter group had a worse toxicity profile (grade 3-4: 52.6% vs. 22.0%; grade 1-2: 89.5% vs. 68.3%).

Conclusions: The BI cohort had higher response rates, almost twice the OS and a lower degree of toxicity in contrast to the PCV group. The small number of patients and historical cohorts limits these comparisons.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Aged
  • Antineoplastic Combined Chemotherapy Protocols / administration & dosage*
  • Bevacizumab / administration & dosage
  • Brain Neoplasms / drug therapy
  • Brain Neoplasms / mortality*
  • Camptothecin / administration & dosage
  • Camptothecin / analogs & derivatives
  • Chemotherapy, Adjuvant / statistics & numerical data
  • Cohort Studies
  • Female
  • Glioblastoma / drug therapy*
  • Glioblastoma / mortality*
  • Humans
  • Irinotecan
  • Lomustine / administration & dosage
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / drug therapy*
  • Neoplasm Recurrence, Local / mortality*
  • Portugal / epidemiology
  • Prevalence
  • Procarbazine / administration & dosage
  • Retrospective Studies
  • Risk Assessment
  • Survival Analysis
  • Survival Rate
  • Treatment Outcome
  • Vincristine / administration & dosage

Substances

  • Bevacizumab
  • Procarbazine
  • Vincristine
  • Irinotecan
  • Lomustine
  • Camptothecin

Supplementary concepts

  • PCV protocol