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Phase II study of bevacizumab and etoposide in patients with recurrent malignant glioma.


Posted on: 10/04/2008

Phase II study of bevacizumab and etoposide in patients with recurrent malignant glioma.


Central Nervous System Tumors


Central Nervous System Tumors


2008 ASCO Annual Meeting

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Abstract No:



J Clin Oncol 26: 2008 (May 20 suppl; abstr 2022)


J. N. Rich, A. Desjardins, S. Sathornsumetee, J. J. Vredenburgh, J. A. Quinn, S. Gururangan, A. H. Friedman, H. S. Friedman, D. A. Reardon


Background: Bevacizumab (BV), a neutralizing monoclonal antibody to vascular endothelial growth factor (VEGF), has demonstrated remarkable radiographic response and promising survival benefit in combination with irinotecan in patients with recurrent glioblastoma multiforme (GBM). In this study, we evaluate the efficacy of bevacizumab when combined with etoposide, a topoisomerase inhibitor, in patients with recurrent malignant glioma (MG). Methods: Recurrent patients with no more than three prior episodes of recurrence are eligible, while those with prior BV treatment or prior intracranial hemorrhage are excluded. The primary outcome measure is 6 month progression-free survival. BV is dosed at 10 mg/kg intravenously every other week. Etoposide is orally administered daily (50 mg/m2) for days 1-21 of each 28-day cycle. Results: Fifty-three patients have enrolled including 27 with GBM, 16 with anaplastic astrocytoma, 8 with anaplastic oligodendroglioma and 2 with malignant pleomorphic xanthoastrocytoma. The median age is 48.7 years (range, 25.2-71.2), and patients have had a median of 2 prior progressions (range, 1-3) and 2 prior therapeutic agents (range, 1-7). The most common significant toxicities include neutropenia (grade 3, n=8; grade 4, n=1), thrombosis (grade 3, n=2, grade 4, n=2; grade 5, n=1), hyponatremia (grade 3, n=3) and infection (grade 3, n=2). Two patients developed grade 1 intracranial hemorrhage. Best responses to date include complete response (n=1; 2%); partial response (n=9; 17%), stable disease (n=34; 60%); progressive disease (n=3; 6%). Six patients are too early to assess.Conclusions: Combination of bevacizumab and etoposide is well tolerated in recurrent MG patients and is associated with encouraging radiographic response. Further accrual, treatment and follow-up are ongoing.

Abstract Disclosures


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