Comparative Study between Bevacizumab Alone and in Combination with Irinotecan in Recurrent Glioblastoma Multiforme | ||||
| The Egyptian Journal of Hospital Medicine | ||||
| Article 29, Volume 100, Issue 1, July 2025, Page 2721-2726 PDF (584.13 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejhm.2025.436802 | ||||
 View on SCiNiTO | ||||
| Abstract | ||||
| ABSTRACT Background: Recurrent glioblastoma multiforme (rGBM) is a highly aggressive tumor that is difficult to treat and has a poor outcome. Bevacizumab (BEV), a monoclonal antibody against vascular endothelial growth factor A, is often used in patients who have received many treatments before, despite its limited ability to prolong survival. The combination of BEV with irinotecan (IRI), a topoisomerase I inhibitor, would potentially optimize its effectiveness. Aim of the work: The aim of this study was to compare between BEV alone and BEV+IRI in rGBM regarding progression-free survival (PFS), vasogenic edema, quality of life (QoL), and overall survival (OS). Methods: We conducted a retrospective study at Tanta University Hospital (2019–2023) on 50 rGBM patients who were divided into two groups: Group I (BEV alone, n=25) and group II (BEV + IRI, n=25). Results: Baseline characteristics were comparable (p>0.05). Group II showed significantly improved median PFS (4.5 vs. 3.5 months, p < 0.001) but not OS (8.0 vs. 8.3 months, p>0.05). Tumor response (RANO criteria) and decrease of vasogenic edema were similar (80% vs. 60% reduction of mild edema, p>0.05). QoL remained steady (72% good QoL post-treatment in both groups, p>0.05). Toxicity profiles were comparable, but there was slightly more hypertension (16% vs. 24%) and leukopenia (12% vs. 0%, p>0.05) in the BEV+IRI arm. Complete/partial resection, ECOG PS1, and age >50 years correlated with better PFS and OS (p < 0.05). Conclusion: BEV+IRI significantly extended PFS in rGBM compared to BEV alone, and it thereby reaffirms its place as a salvage therapy. However, OS and QoL benefits remained elusive, and further efforts are necessary on combination therapy and biomarkers. | ||||
| Keywords | ||||
| Recurrent glioblastoma multiform; Bevacizumab; Irinotecan; Progression-free survival; Vasogenic edema | ||||
|
Statistics Article View: 129 PDF Download: 85 |
||||
