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Бевацизумаб в комбинации с химиолучевой терапией у больных глиобластомой
Бевацизумаб в комбинации с химиолучевой терапией у больных глиобластомой
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Аннотация
Представлен обзор литературы по клиническим исследованиям II и III фазы, изучавшим эффективность и безопасность использования бевацизумаба в комбинации с химиолучевой терапией у больных с впервые диагностированной глиобластомой головного мозга. Приведены данные о статистически значимом увеличении выживаемости без прогрессирования у больных глиобластомой на 4,4 мес и снижении относительного риска прогрессирования или смерти на 36% при применении бевацизумаба в комбинации со стандартной химиолучевой терапией у больных с вновь диагностированной глиобластомой. Показано, что добавление бевацизумаба достоверно увеличивает время до ухудшения статуса Карновского, статуса общего здоровья, физического, социального функционирования, моторного и коммуникационного дефицита. Оценена безопасность применения бевацизумаба в комбинации с химиолучевой терапией. Освещены возможные показания к применению бевацизумаба в 1-й линии терапии, приведены данные собственного опыта применения бевацизумаба по этим показаниям.
Ключевые слова: мультиформная глиобластома, опухоль мозга, химиолучевая терапия, таргетная терапия, антиангиогенная терапия, бевацизумаб.
Key words: glioblastoma multiforme, brain tumor, chemoradiotherapy, target therapy, antiangiogenic therapy, bevacizumab.
Ключевые слова: мультиформная глиобластома, опухоль мозга, химиолучевая терапия, таргетная терапия, антиангиогенная терапия, бевацизумаб.
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Key words: glioblastoma multiforme, brain tumor, chemoradiotherapy, target therapy, antiangiogenic therapy, bevacizumab.
Полный текст
Список литературы
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25. Chinot O, Wick W, Mason W et al. Phase III trial of bevacizumab added to standard radiotherapy and temozolomide for newly-diagnosed glioblastoma: Mature progression-free survival and preliminary overall survival results in AVAglio. Neuro Oncol 2012; 14 (Suppl.). Abstr. OT-03.
26. Wick W, Cloughesy TF, Nishikawa R et al. Tumor response based on adapted Macdonald criteria and assessment of pseudoprogression (PsPD) in the phase III AVAglio trial of bevacizumab (Bv) plus temozolomide (T) plus radiotherapy (RT) in newly diagnosed glioblastoma (GBM). 2013 ASCO Annual Meeting Presented 2013; Abstr. 2002.
27. Henriksson R, Bottomley A, Mason W et al. Progression-free survival (PFS) and health-related quality of life (HRQoL) in AVAglio, a phase III study of bevacizumab (Bv), temozolomide (T), and radiotherapy (RT) in newly diagnosed glioblastoma (GBM). 2013 ASCO Annual Meeting Presented 2013; Abstr. 2005.
28. Aldape KD, Jones G, Wang M et al. MGMT methylation testing in RTOG 0525: A phase III trial of newly diagnosed glioblastoma. ASCO Annual Meeting Proceedings (Post-Meeting Edition). J Clin Oncol 2009; 27 (15S): 2051. Suppl.
29. Sulman EP, Won M, Blumenthal DT et al. Molecular predictors of outcome and response to bevacizumab (BEV) based on analysis of RTOG 0825, a phase III trial comparing chemoradiation (CRT) with and without BEV in patients with newly diagnosed glioblastoma (GBM). J Clin Oncol 2013; 31 (Suppl.). Аbstr. LBA2010.
30. Herrlinger U, Schaefer N, Steinbach JP et al. Bevacizumab, irinotecan, and radiotherapy versus standard temozolomide and radiotherapy in newly diagnosed, MGMT-nonmethylated glioblastoma patients: First results from the randomized multicenter GLARIUS trial. J Clin Oncol 2013; 31 (Suppl.). Аbstr. LBA2000.
2. Kristiansen K, Hagen S, Kollevold T et al. Combined modality therapy of operated astrocytomas grade III and IV. Confirmation of the value of postoperative irradiation and lack of potentiation of bleomycin on survival time: a prospective multicenter trial of the Scandinavian Glioblastoma Study Group Cancer 1981; 47 (4): 649–52.
3. Stupp R, Mason WP, van den Bent MJ et al. Radiotherapy plus concomitant and adjuvant temozolomide for glioblastoma. N Engl J Med 2005; 352 (10): 987–96.
4. Stupp R, Hegi ME, Mason WP et al. Effects of radiotherapy with concomitant and adjuvant temozolomide versus radiotherapy alone on survival in glioblastoma in a randomised phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncol 2009; 10 (5): 459–66.
5. Lacroix M, Abi-Said D, Fourney DR et al. A multivariate analysis of 416 patients with glioblastoma multiforme: prognosis, extent of resection, and survival. J Neurosurg 2001; 95: 190–8.
6. Nieder C, Adam M, Molls M, Grosu AL. Therapeutic options for recurrent high-grade glioma in adult patients: recent advances. Crit Rev Oncol Hematol 2006; 60: 181–93.
7. Brandes AA, Fiorentino MV. The role of chemotherapy in recurrent malignant gliomas: an overview. Cancer Invest 1996; 14: 551–9.
8. Wick W, Steinbach JP, Küker WM et al. One week on/one week off: A novel active regimen of temozolomide for recurrent glioblastoma. Neurology 2004; 62 (11): 2113–5.
9. Perry J, Mason W, Belanger K et al. The Temozolomide RESCUE study: a Phase II trial of continuous (28/28) dose-intense temozolomide (TMZ) after progression on conventional 5/28 day TMZ in patients with recurrent malignant glioma. Clin Oncol 2008; 26 (Suppl. 15). Abstr. 2010.
10. Plate KH, Breier G, Weich HA et al. Vascular endothelial growth factor is a potential tumour angiogenesis factor in human gliomas in vivo. Nature 1992; 359: 845–8.
11. Shweiki D, Itin A, Soffer D et al. Vascular endothelial growth factor induced by hypoxia may mediate hypoxia-initiated angiogenesis. Nature 1992; 359: 843–5.
12. Zagzag D, Zhong H, Scalzitti JM et al. Expression of hypoxia-inducible factor 1a in brain tumors: association with angiogenesis, invasion, and progression. Cancer 2000; 88 (11): 2606–18.
13. Louis DN. Molecular pathology of malignant gliomas. Annu Rev Pathol 2006; 1: 97–117.
14. Jain RK, di Tomaso E, Duda DG et al. Angiogenesis in brain tumours. Nat Rev Neurosci 2007; 8: 610–22.
15. Stark-Vance V: Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma. Neuro Oncology 2005; 7: 369. Аbstr. 342.
16. Stark-Vance V. Bevacizumab and CPT-11 in the treatment of relapsed malignant glioma. Neuro Oncol 2005; 7: 369.
17. Pope WB, Lai A, Nghiemphu P et al. MRI in patients with high-grade gliomas treated with bevacizumab and chemotherapy. Neurol 2006; 66: 1258–60.
18. Vredenburgh JJ, Wefel J, Coughesy T et al. Clinical assessment of corticosteroid use and neurocognitive function in patients with glioblastoma at first or second relapse treated with bevacizumab in the BRAIN study. Eur J Cancer 2009; 7 (Suppl.): 495. Abstr O-8701.
19. Friedman HS, Prados MD, Wen PY et al. Bevacizumab alone and in combination with irinotecan in recurrent glioblastoma. J Clin Oncol 2009; Epub ahead of print.
20. Jain RK. Normalization of tumor vasculature: An emerging concept in antiangiogenic therapy. Science 2005; 307: 58–62.
21. Duda DG, Jain RK, Willett CG. Antiangiogenics: The potential role of integrating this novel treatment modality with chemoradiation for solid cancers. J Clin Oncol 2007; 25: 4033–42.
22. Lai A, Tran A, Nghiemphu PL et al. Phase II trial of bevacizumab plus temozolomide during and after radiation therapy for patients with newly diagnosed glioblastoma multiforme. J Clin Oncol 2011; 29: 142–8.
23. Gruber ML, Raza S, Gruber D, Narayana A. Bevacizumab in combination with radiotherapy plus concomitant and adjuvant temozolomide for newly diagnosed glioblastoma: update progression free survival, overall survival, and toxicity. J Clin Oncol 2009; 27 (Suppl.): 15s. Abstr. 2017.
24. Gilbert MR, Dignam J, Won M. RTOG 0825: Phase III double-blind placebo-controlled trial evaluating bevacizumab (Bev) in patients (Pts) with newly diagnosed glioblastoma (GBM). J Clin Oncol 2013; 31 (Suppl.). Abstr. 1.
25. Chinot O, Wick W, Mason W et al. Phase III trial of bevacizumab added to standard radiotherapy and temozolomide for newly-diagnosed glioblastoma: Mature progression-free survival and preliminary overall survival results in AVAglio. Neuro Oncol 2012; 14 (Suppl.). Abstr. OT-03.
26. Wick W, Cloughesy TF, Nishikawa R et al. Tumor response based on adapted Macdonald criteria and assessment of pseudoprogression (PsPD) in the phase III AVAglio trial of bevacizumab (Bv) plus temozolomide (T) plus radiotherapy (RT) in newly diagnosed glioblastoma (GBM). 2013 ASCO Annual Meeting Presented 2013; Abstr. 2002.
27. Henriksson R, Bottomley A, Mason W et al. Progression-free survival (PFS) and health-related quality of life (HRQoL) in AVAglio, a phase III study of bevacizumab (Bv), temozolomide (T), and radiotherapy (RT) in newly diagnosed glioblastoma (GBM). 2013 ASCO Annual Meeting Presented 2013; Abstr. 2005.
28. Aldape KD, Jones G, Wang M et al. MGMT methylation testing in RTOG 0525: A phase III trial of newly diagnosed glioblastoma. ASCO Annual Meeting Proceedings (Post-Meeting Edition). J Clin Oncol 2009; 27 (15S): 2051. Suppl.
29. Sulman EP, Won M, Blumenthal DT et al. Molecular predictors of outcome and response to bevacizumab (BEV) based on analysis of RTOG 0825, a phase III trial comparing chemoradiation (CRT) with and without BEV in patients with newly diagnosed glioblastoma (GBM). J Clin Oncol 2013; 31 (Suppl.). Аbstr. LBA2010.
30. Herrlinger U, Schaefer N, Steinbach JP et al. Bevacizumab, irinotecan, and radiotherapy versus standard temozolomide and radiotherapy in newly diagnosed, MGMT-nonmethylated glioblastoma patients: First results from the randomized multicenter GLARIUS trial. J Clin Oncol 2013; 31 (Suppl.). Аbstr. LBA2000.
Авторы
А.В.Смолин1, А.В.Конев1, Г.Л.Кобяков2, С.Н.Николаева1, Ю.Е.Шаманская1, А.В.Горбунов1
1 ФГКУ Главный военный клинический госпиталь им. акад. Н.Н.Бурденко Минобороны России
2 НИИ нейрохирургии им. Н.Н.Бурденко РАМН
1 ФГКУ Главный военный клинический госпиталь им. акад. Н.Н.Бурденко Минобороны России
2 НИИ нейрохирургии им. Н.Н.Бурденко РАМН
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