Assessment of the effectiveness and safety of bevacizumab-based therapies for recurrent primary brain tumors: a multicenter real-world study by the Turkish Oncology Group (TOG) - Report - MDSpire
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Assessment of the effectiveness and safety of bevacizumab-based therapies for recurrent primary brain tumors: a multicenter real-world study by the Turkish Oncology Group (TOG)
Real-World Effectiveness and Safety of Bevacizumab-Based Therapies in Recurrent Primary Brain Tumors
Overview
This multicenter retrospective study by the Turkish Oncology Group evaluated the real-world effectiveness and safety of bevacizumab-based regimens in adults with recurrent primary brain tumors. The study included 30 oncology centers in Turkey and assessed treatment outcomes, adverse events, and survival in patients receiving bevacizumab alone or combined with irinotecan.
Background
Glioblastoma is the most common and aggressive primary brain tumor in adults, with limited treatment options upon recurrence. Standard initial treatment includes surgery, radiotherapy, and temozolomide, but most patients experience relapse. Bevacizumab, an anti-VEGF monoclonal antibody, has shown improvements in progression-free survival and response rates in clinical trials but has not consistently demonstrated overall survival benefits. Combining bevacizumab with chemotherapy agents like irinotecan may improve disease control, though real-world data remain limited.
Data Highlights
The study included adult patients with recurrent glioblastoma, anaplastic astrocytoma, or oligodendroglioma treated with bevacizumab-based regimens between 2010 and 2023. Patients were grouped into bevacizumab monotherapy, bevacizumab plus low-dose irinotecan, and bevacizumab plus standard-dose irinotecan. Treatment response was assessed every eight weeks using McDonald criteria. Safety data included gastrointestinal, hematologic, and bevacizumab-associated toxicities.
Key Findings
Bevacizumab-based therapies demonstrated real-world effectiveness in controlling recurrent primary brain tumors, with measurable progression-free survival benefits.
Combination of bevacizumab with irinotecan showed improved radiological response rates and progression-free survival compared to bevacizumab monotherapy, consistent with prior phase II studies.
Overall survival benefits were not significantly different between bevacizumab monotherapy and combination regimens.
Treatment-related adverse events were manageable, with recorded toxicities including gastrointestinal symptoms, hematologic effects, and bevacizumab-specific risks such as hypertension and hemorrhage.
Patient selection based on performance status and prior therapies influenced treatment tolerability and outcomes.
Clinical Implications
Bevacizumab-based regimens, alone or combined with irinotecan, represent viable treatment options for recurrent primary brain tumors in routine clinical practice. Clinicians should consider patient performance status and potential toxicities when selecting therapy. Regular monitoring for adverse events is essential to optimize safety and maintain quality of life during treatment.
Conclusion
This large multicenter real-world study supports the effectiveness and manageable safety profile of bevacizumab-based therapies in recurrent primary brain tumors, reinforcing their role in clinical management despite limited overall survival improvements. Further prospective studies are warranted to refine patient selection and optimize combination strategies.
References
Turkish Oncology Group (TOG) 2024 -- Assessment of the effectiveness and safety of bevacizumab-based therapies for recurrent primary brain tumors
