Lomustine+bevacizumab may increase progression-free, but not overall, survival versus lomustine alone
THURSDAY, Nov. 16, 2017 (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 Nov. 15 in the New England Journal of Medicine.
Wolfgang Wick, M.D., 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 for death, 0.95; 95 percent confidence interval, 0.74 to 1.21; P = 0.65). However, locally assessed progression-free survival was 2.7 months longer in the combination group than in the monotherapy group (hazard ratio for disease progression or death, 0.49; 95 percent confidence interval, 0.39 to 0.61; P < 0.001). Adverse events (grade 3 to 5) occurred in 63.6 percent of the patients in the combination group and 38.1 percent 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,” conclude the authors.
Several authors disclosed financial ties to the pharmaceutical industry, including F. Hoffmann-La Roche, which provided funding for the study.
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