No Survival Benefit With Lomustine Plus Bevacizumab in Glioblastoma

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.

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“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.


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