title: Phase 2 study of carboplatin, irinotecan, and bevacizumab for recurrent glioblastoma after progression on bevacizumab therapy.
abstract: BACKGROUND
  The efficacy of carboplatin, irinotecan, and bevacizumab among recurrent glioblastoma (GBM) patients after prior progression on bevacizumab therapy in a phase 2, open-label, single-arm trial was evaluated.
  
  
  METHODS
  Eligible patients received carboplatin (area under the plasma curve [AUC] 4 mg/ml-min) on day 1, whereas bevacizumab (10 mg/kg) and irinotecan (340 mg/m(2) for patients on CYP3A enzyme-inducing anti-epileptics [EIAEDs] and 125 mg/m(2) for patients not on EIAEDs) were administered on days 1 and 14 of every 28-day cycle. Patients were evaluated after each of the first 2 cycles and then after every other cycle. Treatment continued until progressive disease, unacceptable toxicity, noncompliance, or voluntary withdrawal. The primary end point was progression-free survival at 6 months (PFS-6), and secondary end points included safety and median overall survival (OS).
  
  
  RESULTS
  All patients had progression on at least 1 prior bevacizumab regimen and 56% enrolled after either second or third overall progression. The median OS was 5.8 months (95% confidence interval [CI], 4.0-7.0 months) and PFS-6 rate was 16% (95% CI, 5.0%-32.5%). The most common grade 3 or 4 events were hematologic and occurred in 29% of cycles. Nine patients (38%) required dose modification. There were no treatment-related deaths.
  
  
  CONCLUSIONS
  Carboplatin, irinotecan, and bevacizumab was associated with modest activity and adequate safety among recurrent GBM patients who progressed on bevacizumab previously.
authors: Department of Surgery, The Preston Robert Tisch Brain Tumor Center, Duke University Medical Center, Durham, North Carolina, USA. reard003@mc.duke.edu
authors: David A
authors: DA
authors: Reardon
authors: Annick
authors: A
authors: Desjardins
authors: Katherine B
authors: KB
authors: Peters
authors: James J
authors: JJ
authors: Vredenburgh
authors: Sridharan
authors: S
authors: Gururangan
authors: John H
authors: JH
authors: Sampson
authors: Roger E
authors: RE
authors: McLendon
authors: James E
authors: JE
authors: Herndon
authors: April
authors: A
authors: Coan
authors: Stevie
authors: S
authors: Threatt
authors: Allan H
authors: AH
authors: Friedman
authors: Henry S
authors: HS
authors: Friedman
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