Patterns of bevacizumab use in patients with glioblastoma: an online survey among experts in neuro-oncology

Surabhi Ranjan; Nebojša Skorupan; Xiaobu Ye; Ananyaa Sivakumar; Olga Yankulina; David Kamson; Stuart A Grossman; Omar Dzaye; Matthias Holdhoff

doi:10.1093/nop/npz022

Patterns of bevacizumab use in patients with glioblastoma: an online survey among experts in neuro-oncology

Neurooncol Pract. 2020 Jan;7(1):52-58. doi: 10.1093/nop/npz022. Epub 2019 Jul 6.

Authors

Surabhi Ranjan^{1

2}, Nebojša Skorupan¹, Xiaobu Ye¹, Ananyaa Sivakumar¹, Olga Yankulina¹, David Kamson¹, Stuart A Grossman¹, Omar Dzaye^{1

3

4}, Matthias Holdhoff¹

Affiliations

¹ Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
² National Cancer Institute, Bethesda, MD, USA.
³ Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
⁴ Department of Radiology and Neuroradiology, Charité, Berlin, Germany.

Abstract

Background: Bevacizumab (BEV) received accelerated FDA approval in 2009 for the treatment of recurrent glioblastoma (rGBM). Unfortunately, prospective randomized controlled phase 3 studies (AVAglio and Radiation Therapy Oncology Group 0825 in newly diagnosed, European Organisation for Research and Treatment of Cancer 26101 in rGBM) failed to show an overall survival benefit with BEV added to standard therapy. In light of these data, we aimed to capture current utilization patterns and perceived value of BEV in the treatment of GBM among experts in the field.

Methods: An online questionnaire comprising 14 multiple choice questions was sent out in spring 2017 to 207 oncologists/neuro-oncologists treating patients with GBM at all National Cancer Institute-designated cancer centers in the United States.

Results: Sixty-two of 207 (30%) invitees responded (by training, 70% neuro-oncologists, 20% medical oncologists, 10% pediatric oncologists/neuro-oncologists). Participants reported use of BEV most frequently in rGBM for control of edema (85% of respondents) and/or when no other treatment options were available (68%). BEV is rarely used in newly diagnosed GBM (<5% of cases by 78% respondents and in 5% to 10% cases by 15% respondents). Sixty-six percent of participants indicated that they thought BEV improved symptoms, 30% that it improved symptoms and survival, 3% that it had no benefit in GBM patients.

Conclusion: In this cross-sectional online survey we found that among neuro-oncology experts in the United States in 2017, BEV is predominantly utilized in select patients with rGBM, and is only rarely used in a small subgroup of patients with newly diagnosed GBM for control of edema. The low response rate may have introduced a nonresponse bias.

Keywords: bevacizumab; clinical practice; glioblastoma; recurrent; survey.

© The Author(s) 2019. Published by Oxford University Press on behalf of the Society for Neuro-Oncology and the European Association of Neuro-Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.