ATNT-29TREATMENT OF GLIOBLASTOMA: USE OF BEVACIZUMAB AFTER FIRST PROGRESSION. EXPERIENCE OF 20 DE NOVIEMBRE ISSSTE MEDICAL CENTER, MEXICO CITY

Abstract

In Mexico the incidence of brain tumors was 4786 cases in 2012, 18% of these tumors are glioblastoma, The study was conducted January 2007 to April 2015, with patients diagnosed with glioblastoma, included in the study, after standard treatment (CT/RT) and adjuvant temozolamide. Patients remained under surveillance with IMR. If progression was detected, bevacizumab was initiated at 10mg/Kg until progression; if patient had a good performance after the use of bevacizumab, we added Irinotecan and continued bevacizumab. The primary end point was progression-free survival, the secondary objective was overall survival. Inclusion criteria: Patients diagnosed with glioblastoma, age ≥ 18 years, ECOG 0-2, Karnofsky> 70. Exclusion criteria: Patients without diagnosis of glioblastoma ECOG 3. MATERIALS AND METHODS: 84 cases diagnosed with brain tumors, only 24 patients have glioblastoma. RESULTS: Age was 50 years, 10 women and 14 men, 2 patients with complete resection, 1 with biopsy and 21 remaining with partial resections were 40-80% of the tumor, DFS was 12. 7 months, with an overall survival of 31 months, 8 patients continued bevacizumab and irinotecan after second progression. DISCUSSION: This is the first Mexican study of reported experience with the use of bevacizumab, median overall survival 31 months, with a mean PFS of 12.7 months. We do not make the determination of IDH1, but the benefit of use of bevacizumab after the first progression and continue after second progression exist. we need a biomarker and clinical parameter. CONCLUSIONS: The use of bevacizumab in patients with glioblastoma has free survival similar to other reports, is safe in Mexican population, and some patients receive CT and continue to bevacizumab with increase of OS.