No Survival Benefit With Lomustine Plus Bevacizumab in Glioblastoma

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The researchers found that the median overall survival was 9.1 months in the combination group and 8.6 months in the monotherapy group.
The researchers found that the median overall survival was 9.1 months in the combination group and 8.6 months in the monotherapy group.

HealthDay News — In patients with progressive glioblastoma, treatment with lomustine plus bevacizumab does not confer a survival advantage over treatment with lomustine alone, according to a study published online in the New England Journal of Medicine.

Wolfgang Wick, MD, from the University of Heidelberg in Germany, and colleagues randomly assigned patients with progression after chemoradiation (2-to-1 ratio) to receive lomustine plus bevacizumab (combination group, n=288) or lomustine alone (monotherapy group, n=149 patients).

The researchers found that the median overall survival was 9.1 months in the combination group and 8.6 months in the monotherapy group (hazard ratio [HR] for death 0.95; 95% CI, 0.74-1.21; P =.65). 

However, locally assessed progression-free survival was 2.7 months longer in the combination group than in the monotherapy group (HR for disease progression or death 0.49; 95% CI, 0.39-0.61; P <.001). Adverse events (grade 3 to 5) occurred in 63.6% of the patients in the combination group and 38.1% of the patients in the monotherapy group. Neither health-related quality of life nor neurocognitive function was affected by adding bevacizumab to lomustine.

"The effect on progression-free survival was not associated with an increase in overall survival, and combination therapy was associated with increased toxicity," concluded the investigators.

Disclosures: Several authors disclosed financial ties to the pharmaceutical industry, including F. Hoffmann-La Roche, which provided funding for the study.

Reference

Wick W, Gorlia T, Bendszus M, et al. Lomustine and bevacizumab in progressive glioblastoma. N Engl J Med. 2017;377(20):1954-1963.

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