Effects of bevacizumab plus irinotecan on response and survival in patients with recurrent malignant glioma: a systematic review and survival-gain analysis

BMC Cancer

Research Article

Tao Xu¹  Juxiang Chen¹  Yicheng Lu¹  Johannes EA Wolff² 

[1] Department of Neurosurgery, Changzheng Hospital, Second Military Medical University, 200003, Shanghai, China;Departments of Pediatrics and Biostatistics, The University of Texas M. D. Anderson Cancer Center, Houston, TX, USA;

关键词: Bevacizumab;    Progression Free Survival;    Irinotecan;    Thrombotic Thrombocytopenic Purpura;    Survival Gain;   

DOI  :  10.1186/1471-2407-10-252

 received in 2009-12-08, accepted in 2010-06-02,  发布年份 2010

来源: Springer

【 摘 要 】

BackgroundThe combination of bevacizumab and irinotecan is a new chemotherapy protocol increasingly used for recurrent malignant glioma. Results from phase II trials suggest this drug combination is beneficial to patients, but no conclusive comparisons between this and other treatment protocols have been published.MethodsWe performed a systematic review and survival gain analysis of phase II studies to evaluate the efficacy and safety of bevacizumab plus irinotecan treatment. To do this, we utilized a preexisting database from which the mean overall survival and response rate of patients could be predicted. Survival gain, which characterized the influence of treatment, was defined as the difference between observed and predicted mean overall survival. Response gain was calculated similarly.Results741 cohorts were enrolled in the database. Among them, 282 cohorts were based on recurrent adult HGG, mean reported median overall survival was 10.96 ± 8.4 months, and mean response rate was 18.9% ± 20.5. We found that compared with other treatment protocols, bevacizumab plus irinotecan largely improved response rates (P = 0.00002) and had a possible moderate effect on overall survival time (P = 0.024). Hemorrhage, thromboembolic complications, and gastrointestinal toxicities were the most frequently reported side effects.ConclusionThe combination of bevacizumab and irinotecan might improve outcome in patients with recurrent malignant glioma. Randomized controlled trials are recommended to evaluate this treatment protocol and the additional value of irinotecan.

【 授权许可】

Unknown   
© Xu et al; licensee BioMed Central Ltd. 2010. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.