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Brandes AA, Finocchiaro G, Zagonel V, et al. Early tumour shrinkage as a survival predictor in patients with recurrent glioblastoma treated with bevacizumab in the AVAREG randomized phase II study. Oncotarget. 2017;8(33):55575-55581doi: 10.18632/oncotarget.15735.
Brandes, A. A., Finocchiaro, G., Zagonel, V., Reni, M., Fabi, A., Caserta, C., Tosoni, A., Eoli, M., Lombardi, G., Clavarezza, M., Paccapelo, A., Bartolini, S., Cirillo, L., Agati, R., & Franceschi, E. (2017). Early tumour shrinkage as a survival predictor in patients with recurrent glioblastoma treated with bevacizumab in the AVAREG randomized phase II study. Oncotarget, 8(33), 55575-55581. https://doi.org/10.18632/oncotarget.15735
Brandes, Alba A, et al. "Early tumour shrinkage as a survival predictor in patients with recurrent glioblastoma treated with bevacizumab in the AVAREG randomized phase II study." Oncotarget vol. 8,33 (2017): 55575-55581. doi: https://doi.org/10.18632/oncotarget.15735
Brandes AA, Finocchiaro G, Zagonel V, Reni M, Fabi A, Caserta C, Tosoni A, Eoli M, Lombardi G, Clavarezza M, Paccapelo A, Bartolini S, Cirillo L, Agati R, Franceschi E. Early tumour shrinkage as a survival predictor in patients with recurrent glioblastoma treated with bevacizumab in the AVAREG randomized phase II study. Oncotarget. 2017 Feb 25;8(33):55575-55581. doi: 10.18632/oncotarget.15735. eCollection 2017 Aug 15. PMID: 28903444; PMCID: PMC5589683.
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Oncotarget. 2017 Feb 25;8(33):55575-55581. doi: 10.18632/oncotarget.15735. eCollection 2017 Aug 15.

Early tumour shrinkage as a survival predictor in patients with recurrent glioblastoma treated with bevacizumab in the AVAREG randomized phase II study.

Oncotarget

Alba A Brandes, Gaetano Finocchiaro, Vittorina Zagonel, Michele Reni, Alessandra Fabi, Claudia Caserta, Alicia Tosoni, Marica Eoli, Giuseppe Lombardi, Matteo Clavarezza, Alexandro Paccapelo, Stefania Bartolini, Luigi Cirillo, Raffaele Agati, Enrico Franceschi

Affiliations

  1. Department of Medical Oncology, Bellaria-Maggiore Hospitals, Azienda USL, IRCCS Institute of Neurological Sciences, Bologna, Italy.
  2. Molecular Neuro-Oncology Unit, IRCCS Foundation Carlo Besta, Milan, Italy.
  3. Department of Clinical and Experimental Oncology, Medical Oncology 1, Veneto Institute of Oncology, IRCCS, Padua, Italy.
  4. Department of Medical Oncology, IRCCS San Raffaele, Milan, Italy.
  5. Medical Oncology 1, Regina Elena National Cancer Institute, Rome, Italy.
  6. Oncology Department, Santa Maria Hospital, Terni, Italy.
  7. Medical Oncology Unit, Ente Ospedaliero Ospedali Galliera, Genova, Italy.
  8. Department of Neuroradiology, Bellaria Hospital, IRCCS Institute of Neurological Sciences, Bologna, Italy.

PMID: 28903444 PMCID: PMC5589683 DOI: 10.18632/oncotarget.15735

Abstract

BACKGROUND: Disease assessment for recurrent glioblastoma (GBM) represents a challenge, especially with the use of antiangiogenic agents. Moreover, validated neuroradiological predictors of outcome are lacking. Recently, the concept of early tumor shrinkage (ETS) has been developed to better assess the ability of treatments in determining a rapid and remarkable tumor response. The aim of the study was to evaluate the role of ETS in predicting survival of GBM patients treated with BEV.

METHODS: We examined the radiological data of patients with recurrent GBM treated with bevacizumab (BEV) or fotemustine (FTM) in the randomized phase II AVAREG trial (EudraCT: 2011-001363-46). Radiologic assessments at first disease assessment (day 46) were used to calculate the relative change in the sum of the products of perpendicular diameters of all measurable lesions determined by either T1 contrast and T2/FLAIR.

RESULTS: In patients treated with BEV, the best ETS cut-off was reduction of 15% with T1 contrast and of 40% with T2/FLAIR. Adopting this cut-off for T1 contrast radiological changes, ETS was a significant predictor of OS for patients treated with BEV (HR = 0.511, 95%CI:0.269-0.971,

CONCLUSIONS: ETS evaluating T1 contrast reduction is a helpful predictor of survival in patients with recurrent GBM treated with BEV, and if validated in a larger prospective trial could be a helpful surrogate endpoint.

Keywords: ETS; RANO; bevacizumab; fotemustine; glioblastoma

Conflict of interest statement

CONFLICTS OF INTEREST Dr Reni declares the following conflicts of interest: Celgene; Boehringer; Genetech; Lilly; Merck-Serono; Baxalta; Pfizer; Novocure; Halozyme; Novartis.

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