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- Title
Corticosteroid Use in Patients with Glioblastoma at First or Second Relapse Treated with Bevacizumab in the BRAIN Study.
- Authors
VREDENBURGH, JAMES J.; CLOUGHESY, TIMOTHY; SAMANT, MEGHNA; PRADOS, MICHAEL; WEN, PATRICK Y.; MIKKELSEN, TOM; SCHIFF, DAVID; ABREY, LAUREN E.; YUNG, W. K. ALFRED; PALEOLOGOS, NINA; NICHOLAS, MARTIN K.; JENSEN, RANDY; DAS, ASHA; FRIEDMAN, HENRY S.
- Abstract
Background. Vascular endothelial growth factor inhibitors have corticosteroid-sparing effects in patients with high-grade gliomas. We assessed corticosteroid use in patients with recurrent glioblastoma treated with bevacizumab (BEV) in the BRAIN study (J Clin Oncol 2009;27:4733- 4740). Methods. BRAIN was a phase II, multicenter, randomized, noncomparative trial of BEV alone (n=85) or in combination with irinotecan (CPT-11) (n =82) in adults with recurrent glioblastoma. Median corticosteroid dose for patients who used corticosteroids at baseline was summarized by treatment arm; the percentage of patients who had sustained (≥50% corticosteroid dose reduction for≥50% of time on study drug) or complete (discontinuation of corticosteroid for ≥25% of time on study drug) reduction in corticosteroid dose overall and by objective response and progression-free survival was calculated. The incidence of corticosteroid-related adverse events was summarized. Results. In each treatment group, 50% of patients were using systemic corticosteroids at baseline. The majority of those experienced a reduction in dose while receiving BEV-based therapy. Thirteen (30.2%) BEV and 20 (46.5%) BEV + CPT-11 patients had a sustained reduction of corticosteroid dose; 7 (16.3%) BEV and 9 (20.9%) BEV + CPT-11 patients had a complete reduction of corticosteroid dose. The majority of patients who had an objective response or progression-free survival >6 months experienced corticosteroid dose reduction. Approximately 64% of patients who used corticosteroids while receiving BEV-based therapy experienced infection. Conclusion. BEV may have corticosteroid-sparing effects in patients with recurrent glioblastoma. Corticosteroid reduction may positively affect patient health-related quality of life. Given the exploratory nature of the analyses in a noncomparative study, these results should be interpreted cautiously.
- Subjects
CORTICOSTEROIDS; HORMONE therapy; ANTINEOPLASTIC agents; ENZYME inhibitors; BRAIN tumors; CANCER relapse; EPIDERMAL growth factor; MONOCLONAL antibodies; HEALTH outcome assessment; RANDOMIZED controlled trials; TREATMENT effectiveness
- Publication
Oncologist, 2010, Vol 15, Issue 12, p1329
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2010-0105