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• W2783016713 abstract "Objective: Evaluate safety and efficacy of a decreased Bevacizumab schedule in recurrent/progressive glioblastoma as palliative care. Background: Bevacizumab was approved by the FDA in the treatment of recurrent/progressive glioblastoma with a schedule of IV 10 mg/kg every 2 weeks despite demonstration of impact on survival with phase III studies. Many neuro-oncological centers worldwide apply an off-label prescription at recurrence despite the lack of dose-response studies that raises the question whether current dosing practice is optimal. Design/Methods: Since 2014, we prospectively recruited recurrent/progressive glioblastoma patients after surgery and radiotherapy-temozolomide schedule. Six groups with respectively 6 patients were fulfilled with a decrease mg/kg dose regimen. Patients were treated with the same dosage of Bevacizumab every 2 weeks. Brain MRI was performed every 2 months. Results: 36 patients were recruited: 13 women and 23 men, the mean age at diagnosis was 59.18 years (37–77). The mean time between diagnosis and first Bevacizumab infusion was 38.7 weeks (2.7–112.4). The mean duration of Bevacizumab treatment was 20.8 weeks (0.1–60). Bevacizumab infusions were stopped due to progression (41.7%) or grade III toxicities (41.7%) with no difference regarding dosing. The mean overall survival (OS) was 66.9 weeks (18.3–140.7): G10 mg/kg: 84.8 weeks, G5 mg/kg: 53.9 weeks, G4 mg/kg: 72.2 weeks, G3 mg/kg: 56.3 weeks, G2 mg/kg: 66.4 weeks, G1 mg/kg: 67.4 weeks. MRI response (RANO criteria) was not dependent on dosage. Conclusions: Bevacizumab is used as palliative monotherapy for progressive/recurrent glioblastoma. To date, no study has demonstrated efficacy on OS in adjuvant or recurrent setting. All studies have reported consequent grade III toxicities. Many teams worldwide use a reduced dose of 7.5 mg/kg every 3 weeks based on a meta-analysis showing no difference in OS with 5, 10 or 15 mg/kg every 2 weeks, more long survivors, better tolerance and less cost per month. Using Bevacizumab at lower doses seems to be safe with no evidence of clinico-radiological discrepancies compared with the usual schedule. Studies with larger populations are needed to confirm the proof of concept proposed in our study. Disclosure: Dr. Sirven-Villaros has nothing to disclose. Dr. Bourg has nothing to disclose. Dr. Mondot has nothing to disclose. Dr. Fontaine has nothing to disclose. Dr. Vandenbos has nothing to disclose. Dr. Lebrun Frenay has received personal compensation for activities with Genzyme, Novartis, Biogen, Merck, Teva, and Revue Neurologique as a member of the advisory board." @default.
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• W2783016713 date "2017-04-18" @default.
• W2783016713 modified "2023-10-12" @default.
• W2783016713 title "Bevacizumab : is the lower the better for glioblastoma patients in progression? (P5.167)" @default.
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