Effectiveness of antiangiogenic drugs in glioblastoma patients: A systematic review and meta-analysis of randomized clinical trials

Giuseppe Lombardi, Ardi Pambuku, Luisa Bellu, Miriam Farina, Alessandro Della Puppa, Luca Denaro, Vittorina Zagonel

Research output: Contribution to journalReview article

Abstract

Background glioblastomas are highly vascularized tumors and various antiangiogenic drugs have been investigated in clinical trials showing unclear results. We performed a systematic review and a meta-analysis to clarify and evaluate their effectiveness in glioblastoma patients. Patients and methods we searched relevant published and unpublished randomized clinical trials analyzing antiangiogenic drugs versus chemotherapy in glioblastoma patients from January 2006 to January 2016 in MEDLINE, WEB of SCIENCE, ASCO, ESMO and SNO databases. Results fourteen randomized clinical trials were identified (7 with bevacizumab, 2 cilengitide, 1 enzastaurin, 1 dasatinib, 1 vandetanib, 1 temsirolimus, 1 cediranib) including 4330 patients. Antiangiogenic drugs showed no improvement in overall survival with a pooled HR of 1.00, a trend for an inferior outcome, in terms of overall survival, was observed in the group of patients receiving antiangiogenic drug alone compared to cytotoxic drug alone (HR = 1.24, p = 0.056). Bevacizumab did not improve overall survival. Twelve trials (4113 patients) were analyzed for progression-free survival. Among antiangiogenic drugs, only bevacizumab demonstrated an improvement of progression-free survival (HR = 0.63, p < 0.001), both alone (HR = 0.60, p = 0.003) or in combination to chemotherapy (HR = 0.63; p < 0.001), both as first-line treatment (HR = 0.70, p < 0.001) or in recurrent disease (HR = 0.52, p < 0.001). Conclusions antiangiogenic drugs did not improve overall survival in glioblastoma patients, either as first or second-line treatment, and either as single agent or in combination with chemotherapy. Among antiangiogenic drugs, only bevacizumab improved progression-free survival regardless of treatment line, both as single agent or in combination with chemotherapy

Original languageEnglish
Pages (from-to)94-102
Number of pages9
JournalCritical Reviews in Oncology/Hematology
Volume111
DOIs
Publication statusPublished - Mar 1 2017

Keywords

  • Antiangiogenic drugs
  • Bevacizumab
  • Chemotherapy
  • Glioblastoma

ASJC Scopus subject areas

  • Hematology
  • Oncology
  • Geriatrics and Gerontology

Fingerprint Dive into the research topics of 'Effectiveness of antiangiogenic drugs in glioblastoma patients: A systematic review and meta-analysis of randomized clinical trials'. Together they form a unique fingerprint.

  • Cite this