title: [Single center experience with bevacizumab in a cohort of patients treated for a relapsing glioblastoma].
abstract: OBJECTIVE
  Although there is no standard treatment for recurrent glioblastoma, prospective data in selected patients have suggested the usefulness of bevacizumab. We report our single center experience with bevacizumab in a cohort of patients treated for a relapsing glioblastoma.
  
  
  METHODS
  We performed a retrospective analysis of consecutive patients treated with bevacizumab for a relapsed glioblastoma, between 2008 and 2013. Tumor responses, toxicities, time to progression and overall survival rates were analyzed.
  
  
  RESULTS
  Thirty-five consecutive patients were identified. They were treated with bevacizumab 10mg/kg biweekly, associated with irinotecan (n=29; 84%), temozolomide (n=3; 9%) or as single agent (n=3; 9%) for a glioblastoma relapsing after chemoradiation (n=29) or after first line temozolomide only because of a poor general health status or because of multifocal tumor. Two (6%), 28 (80%) and five (14%) patients presented with Recursive Partitioning Analysis (RPA) III, IV and V-VI, respectively. After 2-3 months of treatment, median dose of prednisolone per patient was decreased three times. Clinical improvements or stability were reported in eight (23%) and 17 patients (49%). The best tumor response was partial response in 14 patients (40%), stable disease in nine patients (26%) and tumor progression in 11 patients (31%). Toxicities requiring treatment disruption were reported in five patients (14%). Median survival was 18.4 months (5-41 months). Median time interval between bevacizumab initiation and its disruption because of clinical/radiological progression and/or toxicity was 5.0 months (0.6-21.4 months). Median survival from bevacizumab initiation was 8.1 months (1.4-34 months).
  
  
  CONCLUSIONS
  This single center retrospective experience suggests that bevacizumab is active for recurrent glioblastoma, in a series of poorly selected patients. Median survival times were in the range of those reported in therapeutic trials. This study questions the validity of usual predictive factors in the era of bevacizumab.
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service d'oncologie radiothérapie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Rodrigue
authors.initials: R
authors.lastname: Mbagui
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de neurologie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Damien
authors.initials: D
authors.lastname: Ricard
authors.affiliation: Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Vallard
authors.affiliation: Institut de cancérologie Lucien-Neuwirth, département de radiothérapie, 108 bis, avenue Albert-Raimond, BP 60008, 42271 Saint-Priest-en-Jarez cedex, France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Magne
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de neurochirurgie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Dulou
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de radiologie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Marion
authors.initials: M
authors.lastname: Lahutte
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de radiologie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Calcina
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de neurologie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Taillia
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de neurochirurgie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Yordanka
authors.initials: Y
authors.lastname: Yordanova
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service de neurochirurgie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Delmas
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service d'oncologie radiothérapie, boulevard du Port-Royal, 75230 Paris, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Bauduceau
authors.affiliation: Hôpital d'instruction des armées du Val-de-Grâce, service d'oncologie radiothérapie, boulevard du Port-Royal, 75230 Paris, France; Gustave-Roussy, Inserm 1030, 114, rue Édouard-Vaillant, 94805 Villejuif cedex, France; Institut de recherche biomédicale des armées, département effet des rayonnements ionisants, 91223 Brétigny-sur-Orge, France. Electronic address: chargari-vdg@hotmail.fr.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
mesh_terms: D000328:Adult; D000368:Aged; D020533:Angiogenesis Inhibitors / Q000627:therapeutic use*; D000068258:Bevacizumab / Q000627:therapeutic use*; D005260:Female; D005909:Glioblastoma / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy* / Q000401:mortality; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D020533:Angiogenesis Inhibitors; D000068258:Bevacizumab