Efficacy and Safety of Bevacizumab Combined with Temozolomide for Recurrent High-Grade Glioma

Dongyan YANG; Hua LIN; Yuxiao ZHANG; Kunying ZHAO; Lirong XIANG; Shuda YANG; Weiyan HU

doi:10.12259/j.issn.2095-610X.S20240410

Volume 45 Issue 4

Apr. 2024

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Article Navigation > Journal of Kunming Medical University > 2024 > 45(4): 67-73

Dongyan YANG, Hua LIN, Yuxiao ZHANG, Kunying ZHAO, Lirong XIANG, Shuda YANG, Weiyan HU. Efficacy and Safety of Bevacizumab Combined with Temozolomide for Recurrent High-Grade Glioma[J]. Journal of Kunming Medical University, 2024, 45(4): 67-73. doi: 10.12259/j.issn.2095-610X.S20240410

Citation:

Dongyan YANG, Hua LIN, Yuxiao ZHANG, Kunying ZHAO, Lirong XIANG, Shuda YANG, Weiyan HU. Efficacy and Safety of Bevacizumab Combined with Temozolomide for Recurrent High-Grade Glioma[J]. Journal of Kunming Medical University, 2024, 45(4): 67-73. doi: 10.12259/j.issn.2095-610X.S20240410

Citation:

Dongyan YANG, Hua LIN, Yuxiao ZHANG, Kunying ZHAO, Lirong XIANG, Shuda YANG, Weiyan HU. Efficacy and Safety of Bevacizumab Combined with Temozolomide for Recurrent High-Grade Glioma[J]. Journal of Kunming Medical University, 2024, 45(4): 67-73. doi: 10.12259/j.issn.2095-610X.S20240410

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Efficacy and Safety of Bevacizumab Combined with Temozolomide for Recurrent High-Grade Glioma

doi: 10.12259/j.issn.2095-610X.S20240410

1.
School of Pharmaceutical Science & Yunnan Key Laboratory of Pharmacology for Natural Products，Kunming Yunnan 650500
2.
Dept. of Pharmacy，The 3rd Affiliated Hospital of Kunming Medical University，Kunming Yunnan 650100
3.
Biomedical Engineering Research Institute of Kunming Medical University，Kunming Yunnan 650500，China

Received Date: 2023-12-26
Available Online: 2024-04-28
Publish Date: 2024-04-29

Abstract

Abstract

Objective To explore the short-term efficacy, safety, and prognostic factors affecting the overall survival （OS） of patients with recurrent high-grade glioma （HGG） treated with bevacizumab （BEV） alone and bevacizumab in combination with temozolomide （TMZ）. Methods According to the response assessment in neurooncology （RANO） criteria for the treatment of gliomas, objective response rate （ORR） and disease control rate （DCR） were used as indicators to retrospectively analyze the clinical medical records of 31 patients with recurrent HGG at Yunnan Cancer Hospital from August 2020 to July 2023. The patients were divided into a control group （BEV） and a treatment group （BEV+TMZ）, and the recent efficacy of the two groups was evaluated. Cox univariate and multivariate analysis methods were used to analyze the impact of group （control group vs. treatment group）, gender, age, disease grading, admission score, histopathological classification, etc., on the overall survival （OS） of 31 patients with recurrent HGG. Adverse reactions （ADR） between the two groups were compared using a chi-square test to evaluate the safety. Results The ORR of the treatment group was 63.16%, and the ORR of the control group was 16.67%. The difference was statistically significant （χ² = 6.419, P = 0.011）. The DCR of the treatment group was 89.47%, and the DCR of the control group was 75.00%. There was no significant difference in DCR （χ² = 0.320, P = 0.571）. The median survival time （mOS） in the control group was 7 months （95%CI: 3.605～10.395）, and the median survival time （mOS） in the treatment group was 14 months （95%CI: 3.853～24.147）. There was no significant difference in mOS between the two groups （χ² = 0.829, P = 0.363）. There were significant differences in Cox univariate analysis admission score and histopathological classification among 31 patients with recurrent HGG （P < 0.05）, and statistically significant differences in histopathological classification by multivariate analysis （P < 0.05）. There was no significant difference in nausea, vomiting, fatigue and diarrhea between the two groups after treatment （P > 0.05）. There were statistically significant differences in the reduction rates of platelets and white blood cells （P < 0.05）, after symptomatic treatment, both groups of ADRs were alleviated. Conclusion The short-term curative effect of the treatment group was better than that of the control group in the treatment of recurrent HGG, the ADRs after recurrent HGG treatment in 2 groups were tolerable and safe, and the histopathological classification may be a prognostic factor affecting the OS of 31 patients with recurrent HGG.
- High-grade glioma,
- Bevacizumab,
- Temozolomide

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References(21)

References

[1]	Miller K D,Ostrom Q T,Kruchko C,et al. Brain and other central nervous system tumor statistics[J]. CA:A Cancer Journal for Clinicians,2021,71(5):381-406. doi: 10.3322/caac.21693
[2]	Louis D N,Perry A,Wesseling P,et al. The 2021 WHO classification of tumors of the central nervous system: A summary[J]. Neuro-Oncology,2021,23(8):1231-1251. doi: 10.1093/neuonc/noab106
[3]	Gritsch S,Batchelor T T,Gonzalez Castro L N. Diagnostic,therapeutic,and prognostic implications of the 2021 world health organization classification of tumors of the central nervous system[J]. Cancer,2022,128(1):47-58. doi: 10.1002/cncr.33918
[4]	Ostrom Q T,Cioffi G,Waite K,et al. CBTRUS statistical report: Primary brain and other central nervous system tumors diagnosed in the united states in 2014-2018[J]. Neuro-Oncology,2021,23(12 Suppl 2):iii1-iii105. doi: 10.1093/neuonc/noab200
[5]	Sahebjam S,Forsyth P A,Tran N D,et al. Hypofractionated stereotactic re-irradiation with pembrolizumab and bevacizumab in patients with recurrent high-grade gliomas: Results from a phase I study[J]. Neuro-Oncology,2021,23(4):677-686. doi: 10.1093/neuonc/noaa260
[6]	Gimbrone M A,Leapman S B,Cotran R S,et al. Tumor dormancy in vivo by prevention of neovascularization[J]. Journal Experimental Medicine,1972,136(2):261-276. doi: 10.1084/jem.136.2.261
[7]	Wick W,Gorlia T,Bendszus M,et al. Lomustine and bevacizumab in progressive glioblastoma[J]. The New England Journal of Medicine,2017,377(20):1954-1963. doi: 10.1056/NEJMoa1707358
[8]	Wen P Y,Macdonald D R,Reardon D A,et al. Updated response assessment criteria for high-grade gliomas: Response assessment in neuro-oncology working group[J]. Journal Clinical Oncology,2010,28(11):1963-1972. doi: 10.1200/JCO.2009.26.3541
[9]	张伟,王政. 中国抗癌协会脑胶质瘤整合诊治指南(精简版)[J]. 中国肿瘤临床,2022,49(16):811-818.
[10]	Ameratunga M,Pavlakis N,Wheeler H,et al. Anti-angiogenic therapy for high-grade glioma[J]. Cochrane Database Syst Rev,2018,11(11):CD008218.
[11]	Xu Y A,Guan H J,Yu K F,et al. Efficacy and safety of pharmacotherapy for recurrent high-grade glioma: A systematic review and network meta-analysis.[J]. Fronts in Pharmacology,2023,14:1191480. doi: 10.3389/fphar.2023.1191480
[12]	Chen Y L,Guo L B,Li X Z,et al. Reduced-dose bevacizumab vs. standard-dose bevacizumab in recurrent high-grade glioma: Which one is better? A meta-analysis[J]. Clinical Neurology and Neurosurgery,2020,198:106239. doi: 10.1016/j.clineuro.2020.106239
[13]	汪思亮,盛晓波,韦忠红,等. 肿瘤血管正常化与肿瘤治疗[J]. 肿瘤,2013,33(07):653-657.
[14]	Bergers G, Hanahan D, Modes of resistance to anti-angiogenic therapy [J]. Nature Reviews Cancer, 2008, 8（8）: 592-603.
[15]	Pàez-Ribes M,Allen E,Hudock J,et al. Antiangiogenic therapy elicits malignant progression of tumors to increased local invasion and distant metastasis[J]. Cancer Cell,2009,15(3):220-231. doi: 10.1016/j.ccr.2009.01.027
[16]	Jain R K. Normalizing tumor vasculature with anti-angiogenic therapy: A new paradigm for combination therapy[J]. Nature Medicine,2001,7(9):987-989. doi: 10.1038/nm0901-987
[17]	张静,张文超,钱子君,等. 血管正常化提高肿瘤治疗疗效[J]. 中国癌症杂志,2016,26(2):188-192.
[18]	Macdonald D R, Temozolomide for recurrent high-grade glioma [J]. Seminars in Oncology, 2001, 28（Suppl 13）: 3-12.
[19]	崔润,郭琤琤,郭颖,等. 贝伐珠单抗治疗复发胶质母细胞瘤疗效和预后分析[J]. 中国肿瘤临床,2022,49(21):1088-1093.
[20]	Armstrong T S,Cao Y,Scheurer M E,et al. Risk analysis of severe myelotoxicity with temozolomide: The effects of clinical and genetic factors[J]. Neuro Oncology,2009,11(6):825-32. doi: 10.1215/15228517-2008-120
[21]	Saran F,Chinot O L,Henriksson R,et al. Bevacizumab,temozolomide,and radiotherapy for newly diagnosed glioblastoma: Comprehensive safety results during and after first-line therapy[J]. Neuro Oncology,2016,18(7):991-1001. doi: 10.1093/neuonc/nov300

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