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Int. J. Mol. Sci. 2017, 18(11), 2469; https://doi.org/10.3390/ijms18112469

Bevacizumab for Patients with Recurrent Multifocal Glioblastomas

1
Dr. Senckenberg Institute of Neurooncology, Goethe University Hospital, 60528 Frankfurt, Germany
2
Institute of Neuroradiology, Goethe University Hospital, 60528 Frankfurt, Germany
3
Institute of Neurology (Edinger Institut), Goethe University Hospital, 60528 Frankfurt, Germany
4
Department of Neurosurgery, Goethe University Hospital, 60528 Frankfurt, Germany
*
Author to whom correspondence should be addressed.
Received: 27 September 2017 / Revised: 15 November 2017 / Accepted: 16 November 2017 / Published: 20 November 2017
(This article belongs to the Section Molecular Pathology, Diagnostics, and Therapeutics)
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Abstract

In patients with glioblastoma, antiangiogenic therapy with bevacizumab (BEV) has been shown to improve progression-free survival (PFS), but not overall survival (OS). Especially in patients with an unusual infiltrative phenotype as seen in multifocal glioblastoma, the use of BEV therapy is still more controversial. Therefore, we prepared a retrospective case series with 16 patients suffering from a multifocal glioblastoma treated with BEV. We compared these patients to a matched control cohort of 16 patients suffering from glioblastoma with a single lesion treated with BEV. The objective of this study was to evaluate whether the course of disease differs in glioblastoma patients with a multifocal disease pattern compared to those with a single lesion only. Patients were treated with BEV monotherapy or BEV in combination with irinotecan or lomustine (CCNU). Response rates and PFS were similar in both groups. There was a trend for an unfavorable OS in the patient group with multifocal glioblastoma, which was expected due to the generally worse prognosis of multifocal glioblastoma. We investigated whether BEV therapy affects the invasive growth pattern as measured by the appearance of new lesions on magnetic resonance imaging (MRI). Under BEV therapy, there was a trend for a lower frequency of new lesions both in multifocal and solitary glioblastoma. Based on these results, BEV therapy at relapse appears to be justified to no lesser extent in multifocal glioblastoma than in solitary glioblastoma. View Full-Text
Keywords: glioblastoma; multifocal; bevacizumab; anti-angiogenic therapy; invasive growth; infiltration glioblastoma; multifocal; bevacizumab; anti-angiogenic therapy; invasive growth; infiltration
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Burger, M.C.; Breuer, S.; Cieplik, H.C.; Harter, P.N.; Franz, K.; Bähr, O.; Steinbach, J.P. Bevacizumab for Patients with Recurrent Multifocal Glioblastomas. Int. J. Mol. Sci. 2017, 18, 2469.

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