A retrospective analysis from the AVAglio (Avastin in Glioblastoma) trial showed that first-line bevacizumab treatment may provide overall survival (OS) in patients with isocitrate dehydrogenase 1 (IDH1) wild-type proneural glioblastoma, according to an article published online ahead of print in the Journal of Clinical Oncology.
The AVAglio and RTOG-0825 randomized, placebo-controlled phase 3 trials in newly diagnosed glioblastoma showed prolonged progression-free survival (PFS) but not OS with the addition of bevacizumab to radiotherapy plus temozolomide in patients with newly diagnosed glioblastoma.
In the retrospective analysis, researchers evaluated PFS and OS in patients who received bevacizumab in addition to first-line standard of care therapy.
A total of 349 pretreatment specimens (bevacizumab arm, n = 171; placebo arm = 178) from AVAglio patients were available for biomarker analysis. Samples were retrospectively evaluated for molecular subtype, gene expression, and IDH1 mutation status.
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Results showed that bevacizumab added a significant OS advantage compared with placebo (17.1 vs. 12.8 months, respectively; HR, 0.43; 95% CI: 0.26–0.73; P=.002).
Patients with mesenchymal and proneural subtypes showed a PFS benefit from bevacizumab, but only those with proneural subtypes demonstrated OS benefit. Further studies are required to validate this predictive value in an independent data set.
- Sandmann, T, Bourgon, R, Garcia J, et al. Patients with proneural glioblastoma may derive overall survival benefit from the addition of bevacizumab to first-line radiotherapy and temozolomide: retrospective analysis of the AVAglio trial. J Clin Oncol. 2015. doi: 10.1200/JCO.2015.61.5005.