title: Neurocognitive function in patients with recurrent glioblastoma treated with bevacizumab.
abstract: Neurocognitive decline is a frequent adverse effect of glioblastoma. Antitumor therapies that are efficacious, as measured by traditional endpoints such as objective response (OR) and progression-free survival (PFS), and have beneficial effects on neurocognitive function (NCF) are of clinical benefit to these patients. We evaluated neurocognitive changes across time in 167 patients with recurrent glioblastoma treated with bevacizumab-based therapy in BRAIN, a phase II, randomized, multicenter trial. All patients underwent MRI and neurocognitive testing at baseline and every 6 weeks thereafter. Memory, visuomotor scanning speed, and executive function were evaluated using the Hopkins Verbal Learning Test-Revised, the Trail Making Test, and the Controlled Oral Word Association test, respectively. NCF relative to baseline for patients with an OR, PFS >6 months, or disease progression was evaluated at time of OR, 24 weeks, and time of progression, respectively. For patients with an OR or PFS >6 months, median standardized test scores were examined from baseline to week 24. Most patients with an OR or PFS >6 months had poorer NCF performance compared to the general population at baseline and had improved or stable NCF at the time of response or at the 24-week assessment, respectively; most patients with progressive disease had neurocognitive decline at the time of progression. For patients with an OR or PFS >6 months, median standardized test scores were largely stable across the first 24 weeks on study. Neurocognitive testing was an objective, valid, and feasible method of monitoring NCF in patients with recurrent glioblastoma.
authors.affiliation: Section of Neuropsychology, Department of Neuro-Oncology, Unit 431, The University of Texas MD Anderson Cancer Center, P.O. Box 301402, Houston, TX 77230-1402, USA. jwefel@mdanderson.org
authors.forename: Jeffrey S
authors.initials: JS
authors.lastname: Wefel
authors.forename: Timothy
authors.initials: T
authors.lastname: Cloughesy
authors.forename: James L
authors.initials: JL
authors.lastname: Zazzali
authors.forename: Maoxia
authors.initials: M
authors.lastname: Zheng
authors.forename: Michael
authors.initials: M
authors.lastname: Prados
authors.forename: Patrick Y
authors.initials: PY
authors.lastname: Wen
authors.forename: Tom
authors.initials: T
authors.lastname: Mikkelsen
authors.forename: David
authors.initials: D
authors.lastname: Schiff
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Abrey
authors.forename: W K Alfred
authors.initials: WK
authors.lastname: Yung
authors.forename: Nina
authors.initials: N
authors.lastname: Paleologos
authors.forename: Martin K
authors.initials: MK
authors.lastname: Nicholas
authors.forename: Randy
authors.initials: R
authors.lastname: Jensen
authors.forename: James
authors.initials: J
authors.lastname: Vredenburgh
authors.forename: Asha
authors.initials: A
authors.lastname: Das
authors.forename: Henry S
authors.initials: HS
authors.lastname: Friedman
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* / Q000523:psychology; D003071:Cognition / Q000187:drug effects*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D005909:Glioblastoma / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000188:drug therapy* / Q000523:psychology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D000911:Antibodies, Monoclonal; D061067:Antibodies, Monoclonal, Humanized; D000068258:Bevacizumab