title: Carboplatin and etoposide combined with bevacizumab for the treatment of recurrent glioblastoma multiforme.
abstract: Relapsed glioblastoma multiforme (GBM) responds poorly to standard therapies. Vascular endothelial growth factor (VEGF) is implicated in the development of GBM and the anti-VEGF monoclonal antibody bevacizumab has shown early clinical promise against malignant glioma. We treated six patients with recurrent GBM using bevacizumab combined with carboplatin and etoposide chemotherapy (ACE regimen). Toxicity was that expected for carboplatin and etoposide alone, except for an ischemic stroke in one patient. We observed partial responses in five patients and one responding patient developed extensive tumour necrosis after 2 cycles of treatment. Median progression-free and overall survival was 19 and 29.9weeks, respectively. Four responding patients developed recurrence, which was characterized by markedly less peri-tumoral edema, mass effect and necrosis compared with tumours at baseline. Two patients developed local extracranial extension. In conclusion, ACE was active in recurrent GBM and was mostly well tolerated.
authors.affiliation: Department of Medical Oncology, Royal Brisbane and Women's Hospital, Herston, Queensland, Australia.
authors.forename: Alessandra B
authors.initials: AB
authors.lastname: Francesconi
authors.forename: Simon
authors.initials: S
authors.lastname: Dupre
authors.forename: Marco
authors.initials: M
authors.lastname: Matos
authors.forename: David
authors.initials: D
authors.lastname: Martin
authors.forename: Brett G
authors.initials: BG
authors.lastname: Hughes
authors.forename: David K
authors.initials: DK
authors.lastname: Wyld
authors.forename: Jason D
authors.initials: JD
authors.lastname: Lickliter
mesh_terms: D000328:Adult; D000911:Antibodies, Monoclonal / Q000008:administration & dosage; D061067:Antibodies, Monoclonal, Humanized; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000628:therapy*; D016190:Carboplatin / Q000008:administration & dosage; D018572:Disease-Free Survival; D005047:Etoposide / Q000008:administration & dosage; D005260:Female; D005909:Glioblastoma / Q000401:mortality / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D005047:Etoposide; D016190:Carboplatin