Martin J. van den Bent, MD, professor, Neuro-Oncology, Erasmus MC-Daniel den Hoed Cancer Center, Rotterdam, The Netherlands, discusses the BELOB trial, which examined bevacizumab versus bevacizumab plus lomustine versus single agent lomustine in patients with recurrent glioblastoma.
Van den Bent says bevacizumab has demonstrated responses in patients with recurrent glioblastoma but it has been unclear so far if it also elicits an increase in overall survival in this population. In trials that examine patients with newly diagnosed glioblastomas, the addition of bevacizumab to radiation and temozolomide increases progression-free survival without effecting overall survival.
The BELOB trial is the first trial that addresses the question of whether bevacizumab helps increase overall survival in recurrent glioblastoma, van den Bent says. This randomized, phase II trial showed that despite the high response rate in bevacizumab treated patients, the overall survival of bevacizumab single-agent patients does not look superior compared to lomustine as a single agent. However, the combination of these two agents demonstrated a benefit, van den Bent says.
At nine months, 38% of patients treated with bevacizumab were alive, 43% of patients treated with lomustine were alive, and 59% of patients treated with the combination of the two agents were alive, van den Bent says.
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