NCOG-16. REAL-WORLD ANALYSIS OF OUTCOMES OF PATIENTS RECEIVING BEVACIZUMAB FOR RECURRENT GLIOBLASTOMA. (14th November 2022)

• Record Type: Journal Article
• Authors: Chahal, Manik; Harrison, Rebecca; Mhurchu, Elaine Ni; Thiessen, Brian
• Is Part Of: Neuro-oncology. Volume 24(2022)Supplement 7
• Page Start: vii200
• Page End: vii200
• Publication Date: 2022-11-14
• Subjects: Brain Neoplasms -- Periodicals; Brain -- Tumors -- Periodicals; Brain -- Cancer -- Periodicals; Nervous system -- Cancer -- Periodicals; 616.99481
• DOI: 10.1093/neuonc/noac209.769
• Languages: English
• ISSNs: 1522-8517

Abstract

Abstract: Bevacizumab has been publicly funded in British Columbia (BC) since 2011 for treatment of recurrent glioblastoma (rGBM). We performed a retrospective analysis of patients with rGBM treated with bevacizumab to evaluate treatment practices and outcomes. 245 patients with rGBM treated at BC Cancer centers with bevacizumab between January 2011 and December 2019 were reviewed. Patient demographics, tumor characteristics, treatment regimens, and dates and type of radiographic progression and death were collected. Kaplan-Meier method was used to assess overall survival from time of bevacizumab initiation (BevOS), and comparisons were made using the log-rank test. Median OS was 7 months (CI95 = 6.28-7.73) from bevacizumab initiation. 66% of patients on corticosteroids prior to bevacizumab reduced their dose, and performance status was the same or improved in 84% of patients shortly after initiation, suggesting improvement in quality of life. Patients started on bevacizumab < 6 months from chemoradiation (prior to completion of adjuvant temozolomide) had improved BevOS compared to those who started bevacizumab later ( p = 0.019), but there was no association between extent of treatment prior to bevacizumab and outcomes ( p = 0.417). Additionally, patients who had local progression prior to bevacizumab initiation had improved BevOS compared to those who had distant progression ( p = 0.004), suggesting that pseudoprogression may have prompted the therapeutic switch. Furthermore, though there were no differences in baseline characteristics for patients treated at high volume centers vs. low volume centers, patients treated at high volume centers had improved BevOS ( p = 0.004), potentially due to differences in expertise between centers or other social determinants of health not captured in baseline demographics. Together, these data highlight the need for optimization of patient selection and bevacizumab administration in high and low volume centers.