What is the role of bevacizumab the treatment of glioblastoma multiforme (GBM)?

Updated: Jul 28, 2021
  • Author: Jeffrey N Bruce, MD; Chief Editor: Herbert H Engelhard, III, MD, PhD, FACS, FAANS  more...
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Answer

The anti-angiogenic agent bevacizumab was approved by the FDA for recurrent glioblastoma in 2009. [98] When used with irinotecan, bevacizumab improved 6-month survival in recurrent glioma patients to 46%, compared with 21% in patients treated with temozolomide. [99, 100]  The anti-angiogenic effect of bevacizumab also decreases peritumoral edema, potentially reducing the necessary corticosteroid dose. The bevacizumab-irinotecan combination for recurrent glioblastoma multiforme has been shown to improve survival over bevacizumab alone. [101]

A population-based analysis of 5607 adult patients with glioblastoma in the SEER (Surveillance Epidemiology and End Results) database found that bevacizumab therapy may improve survival. In the study, glioblastoma patients who died in 2010 (after the FDA approved bevacizumab for this condition) survived significantly longer than those who died of the disease in 2008. Median survival was 8 months for patients who died in 2006, 7 months in 2008, and 9 months in 2010. This difference in survival was highly significant between 2008 (pre-bevacizumab) and 2010 (post-bevacizumab). This survival difference was unlikely due to improvements in supportive care during this time interval, because there was no significant difference between those who died in 2006 and patients who died 2 years later, in 2008. [102, 103]


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