title: Clinical outcome with bevacizumab in patients with recurrent high-grade glioma treated outside clinical trials.
abstract: BACKGROUND
  Patients with recurrent high-grade glioma (HGG) have a poor prognosis and there is no defined standard of care. High levels of vascular endothelial growth factor (VEGF) expressed in HGG make the anti-VEGF monoclonal antibody bevacizumab (BEV) of particular interest.
  
  
  METHODS
  In an ongoing registry data were collected from patients who have received BEV for the treatment of recurrent HGG. The primary objective was the identification of any clinical benefit as assessed by change in Karnofsky Performance Score (KPS), decreased steroid use and duration of treatment.
  
  
  RESULTS
  Two hundred and twenty-five patients with HGG were included (176 glioblastoma; 49 anaplastic glioma; median age 52 years). KPS improved in 10% of patients and remained stable in 68%. Steroids were stopped in 37.6% of patients. Median duration of treatment was 5.5 months; 19.1% of patients were treated for more than 12 months. Median overall survival from beginning of BEV treatment was 8.5 months. At the time of analysis, 169 patients (75.1%) had died and 56 patients (24.9%) were alive. Only 21 patients (9.3%) discontinued treatment due to toxicity.
  
  
  CONCLUSIONS
  Our data reveal valuable palliation with preservation of KPS and an option for steroid withdrawal in patients treated with BEV, supporting the role of this therapy in late-stage disease.
authors.affiliation: Department of Oncology, University Hospital Zurich, Switzerland. silvia.hofer@usz.ch
authors.forename: Silvia
authors.initials: S
authors.lastname: Hofer
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Elandt
authors.forename: Richard
authors.initials: R
authors.lastname: Greil
authors.forename: Andreas F
authors.initials: AF
authors.lastname: Hottinger
authors.forename: Urs
authors.initials: U
authors.lastname: Huber
authors.forename: Dieter
authors.initials: D
authors.lastname: Lemke
authors.forename: Christine
authors.initials: C
authors.lastname: Marosi
authors.forename: Adrian
authors.initials: A
authors.lastname: Ochsenbein
authors.forename: Josef
authors.initials: J
authors.lastname: Pichler
authors.forename: Ulrich
authors.initials: U
authors.lastname: Roelcke
authors.forename: Patrik
authors.initials: P
authors.lastname: Weder
authors.forename: Thilo
authors.initials: T
authors.lastname: Zander
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Wick
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000627:therapeutic use*; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D002986:Clinical Trials as Topic; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012008:Recurrence; D012042:Registries; D059039:Standard of Care; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab