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    A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma

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    TY - GEN T1 - A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma UR - http://hdl.handle.net/20.500.12495/2018 PB - Springer AB - ER - @misc{20.500.12495_2018, author = {}, title = {A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma}, year = {}, abstract = {}, url = {http://hdl.handle.net/20.500.12495/2018} }RT Generic T1 A comprehensive analysis of factors related to carmustine/bevacizumab response in recurrent glioblastoma LK http://hdl.handle.net/20.500.12495/2018 PB Springer AB OL Spanish (121)
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    Author
    Cardona-Mendoza, Andrés Felipe 
    Rojas, Leonardo
    Wills, Beatriz
    Ruiz Patiño, Alejandro
    Abril, Lina Alejandra
    Jiménez, Encarnación
    Useche, Nicolás
    Bermúdez, Sonia
    Mejia, Juan Alberto
    Ramón, Juan Fernando
    Carranza, Hernán
    Vargas, César
    Otero, Jorge
    Archila, Pilar
    Rodríguez, Jaime
    Behaine, José
    González, Daniel
    Jacobo, Juan
    Cifuentes, Héctor
    Feo, Oscar
    Penagos, Pedro
    Pineda, David
    Ricaurte, Luisa María
    Pino, Luis Eduardo
    Vargas, Carlos Andrés
    Márquez, Joana
    Mantilla, Monica
    Ortiz, Leon D.
    Balaña, Carme
    Rosell, Rafael
    Zatarain-Barrón, Zyanya Lucia
    Arrieta, Oscar
    Hakim, Fernando
    Published in
    Clinical and Translational Oncology, 1699-048X, Vol. 21, 2019, p.1364-1373
    Published for
    Springer
    URI
    http://hdl.handle.net/20.500.12495/2018
    Source's URL
    https://link.springer.com/article/10.1007%2Fs12094-019-02066-2
    DOI
    https://doi.org/10.1007/s12094-019-02066-2

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    Abstract
    Purpose Patients with recurrent glioblastoma (rGBM) have a poor prognosis, with survival ranging from 25 to 40 weeks. Antiangiogenic agents are widely used, showing a variable response. In this study, we explored the efcacy of carmustine plus bevacizumab (BCNU/Bev) for treating rGBM. Methods/patients In this study, we assessed 59 adult patients with histologically confrmed rGBM who were treated with BCNU/Bev as second-line regimen. The response rate (RR), progression-free survival (PFS) and overall survival (OS) were evaluated according to their molecular expression profle, including CD133 mRNA expression, MGMT methylation (pMGMT), PDGFR amplifcation, YKL40 mRNA expression, IDH1/2 condition, p53 and EGFRvIII mutation status. Results Median follow-up was 18.6 months, overall RR to the combination was 56.3%, and median PFS was 9.0 months (95% CI 8.0–9.9). OS from time of diagnosis was 21.0 months (95% CI 13.2–28.7) and from starting BCNU/Bev it was 10.7 months (95% CI 9.5–11.8). IDH1/2 mutations were found in 30.5% of the patients, pMGMT in 55.9% and high CD133 mRNA expression in 57.6%. Factors which positively afected PFS included performance status (p=0.015), IDH+ (p=0.05), CD133 mRNA expression (p=0.009) and pMGMT+ (p=0.007). OS was positively afected by pMGMT+ (p=0.05). Meanwhile, YKL40 negatively afected PFS (p=0.01) and OS (p=0.0001). Grade≥3 toxicities included hypertension (22%) and fatigue (12%). Conclusions BCNU/Bev is a safe and tolerable treatment for rGBM. Patients with MGMT+/IDH+ derive the greatest beneft from the treatment combination in the second-line setting. Nonetheless, high YKL40 expression discourages the use of antiangiogenic therapy.
    Keywords
    Glioblastoma
    Second-line therapy
    Bevacizumab
    Molecular expression classifcation
    Topics
    Neoplasias neuroepiteliales
    Anticuerpos monoclonales
    Impresión molecular
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