Although outcome following
bevacizumab among recurrent grade IV
malignant glioma patients is documented as poor by several analyses, outcome for recurrent grade III patients following
bevacizumab therapy has not been specifically evaluated. We performed a pooled analysis of 96 recurrent grade III
malignant glioma patients enrolled on three consecutive phase II
bevacizumab salvage trials to evaluate overall outcome following
bevacizumab trial discontinuation. Outcome on the three
bevacizumab trials, which included similar eligibility, treatment and assessment criteria, was comparable. Forty-nine patients who progressed on
bevacizumab trial
therapy and remained alive for at least 30 days elected to receive additional
therapy. These patients achieved a median PFS-6 and OS of 30.6% (95% CI: 18.4, 43.6) and 10.3 months (95% CI: 5.2, 11.7), respectively. Among patients who continued
bevacizumab therapy (n = 23) after study progression, PFS-6 and median OS were 39.1% (95% CI: 19.9, 58.0) and 9.2 months (95% CI: 5.2, 13.6), respectively, compared to 23.1% (95% CI: 9.4, 40.3; P = 0.51) and 10.3 months (95% CI: 2.5, 14.4; P = 0.91) for patients who initiated non-
bevacizumab containing
therapy (n = 26). Outcome after discontinuation of
bevacizumab therapy for recurrent grade III
malignant glioma patients is associated with improved outcome compared to historical data for recurrent grade IV
malignant glioma patients.
Salvage therapies following
bevacizumab failure have modest activity for grade III
malignant glioma patients that is independent of further
bevacizumab continuation.