QOL-19PROSPECTIVE EVALUATION OF CARDIOPULMONARY FITNESS IN NEWLY DIAGNOSED GLIOBLASTOMA PATIENTS RECEIVING AN ANTI-ANGIOGENIC REGIMEN

Abstract

Anti-angiogenics, such as bevacizumab, a humanized monoclonal antibody to vascular endothelial growth factor, are now commonly used in patients with glioblastoma (GBM). With increased use of anti-angiogenics and the importance of maintaining physical function in patients with cancer, including GBM, we sought to evaluate the cardiopulmonary fitness of GBM patients on bevacizumab-containing treatment regimens. In this prospective cohort study, we recruited 18 newly diagnosed GBM patients initiated on a bevacizumab-containing treatment regimen with standard chemoradiation. Cardiopulmonary fitness was assessed using a physician-supervised cardiopulmonary exercise testing with EKG monitoring leads in order to measure relativeVO2 peak, a measure of cardiopulmonary fitness. Study assessments were planned at baseline, after concurrent chemoradiation, after 6 cycles of adjuvant chemotherapy, and after 12 cycles of adjuvant chemotherapy. In this study, 10 of the 18 patients completed baseline testing and at least one follow-up study assessment. Majority of patients were male (70%) and all had gross total resection. KPS ranged from 70-90 with a majority having a KPS = 90 (60%). Mean age at testing was 51.4 years (sd = 13.3 years). Baseline relative VO2 peak was 22.2 mL/kg/min (sd = 6.3 mL/kg/min). After concurrent chemoradiation with bevacizumab, eight patients had testing and relative VO2 peak was 23.1 mL/kg/min (sd = 8.7 mL/kg/min). Five of 10 patients underwent assessment after 6 cycles of adjuvant chemotherapy and there was a non-significant minor increase in relative VO2 peak compared to baseline scores for these 5 patients. One key limitation was maintaining regular testing for patients enrolled, and this was challenging due to disease progression and associated treatment toxicities that precluded use of an anti-angiogenic regimen and/or cardiopulmonary exercise testing. From this study, we can conclude that some GBM patients can undergo cardiopulmonary exercise testing and that, in this small cohort of patients, cardiopulmonary fitness remained relatively intact during treatment regimen with anti-angiogenic therapy.