Quality of life in the GLARIUS trial randomizing bevacizumab/irinotecan versus temozolomide in newly diagnosed, MGMT-nonmethylated glioblastoma

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Niklas Schäfer - , University of Bonn (Author)
  • Martin Proescholdt - , University of Regensburg (Author)
  • Joachim P. Steinbach - , University Hospital Frankfurt (Author)
  • Astrid Weyerbrock - , University of Freiburg (Author)
  • Peter Hau - , University of Regensburg (Author)
  • Oliver Grauer - , University of Münster (Author)
  • Roland Goldbrunner - , University of Cologne (Author)
  • Franziska Friedrich - , Leipzig University (Author)
  • Veit Rohde - , University of Göttingen (Author)
  • Florian Ringel - , Technical University of Munich (Author)
  • Uwe Schlegel - , Ruhr University Bochum (Author)
  • Michael Sabel - , Heinrich Heine University Düsseldorf (Author)
  • Michael W. Ronellenfitsch - , University Hospital Frankfurt (Author)
  • Martin Uhl - , University of Regensburg (Author)
  • Stefan Grau - , University of Cologne (Author)
  • Mathias Hänel - , Klinikum Chemnitz gGmbH (Author)
  • Oliver Schnell - , Ludwig Maximilian University of Munich (Author)
  • Dietmar Krex - , Department of Neurosurgery, TUD Dresden University of Technology (Author)
  • Peter Vajkoczy - , Charité – Universitätsmedizin Berlin (Author)
  • Ghazaleh Tabatabai - , University of Tübingen (Author)
  • Frederic Mack - , University of Bonn (Author)
  • Christina Schaub - , University of Bonn (Author)
  • Theophilos Tzaridis - , University of Bonn (Author)
  • Michael Nießen - , University of Bonn (Author)
  • Sied Kebir - , University of Bonn (Author)
  • Barbara Leutgeb - , University of Regensburg (Author)
  • Horst Urbach - , University of Freiburg (Author)
  • Claus Belka - , Ludwig Maximilian University of Munich (Author)
  • Walter Stummer - , University of Münster (Author)
  • Martin Glas - , University of Bonn, University of Duisburg-Essen (Author)
  • Ulrich Herrlinger - , University of Bonn (Author)

Abstract

Background The GLARIUS trial, which investigated the efficacy of bevacizumab (BEV)/irinotecan (IRI) compared with standard temozolomide in the first-line therapy of O 6 -methylguanine-DNA methyltransferase (MGMT)-nonmethylated glioblastoma, showed that progression-free survival was significantly prolonged by BEV/IRI, while overall survival was similar in both arms. The present report focuses on quality of life (QoL) and Karnofsky performance score (KPS) during the whole course of the disease. Methods Patients (n = 170) received standard radiotherapy and were randomized (2:1) for BEV/IRI or standard temozolomide. At least every 3 months KPS was determined and QoL was measured using the European Organisation for Research and Treatment of Cancer 30-item Core Quality of Life and 20-item Brain Neoplasm questionnaires. A generalized estimating equation (GEE) model evaluated differences in the course of QoL and KPS over time. Also, the time to first deterioration and the time to postprogression deterioration were analyzed separately. Results In all dimensions of QoL and KPS, GEE analyses and time to first deterioration analyses did not detect significant differences between the treatment arms. At progression, 82% of patients receiving second-line therapy in the standard arm received BEV second-line therapy. For the dimensions of motor dysfunction and headaches, time to postprogression deterioration was prolonged in the standard arm receiving crossover second-line BEV in the vast majority of patients at the time of evaluation. Conclusions GLARIUS did not find indications for a BEV-induced detrimental effect on QoL in first-line therapy of MGMT-nonmethylated GBM patients. Moreover, GLARIUS provided some indirect corroborative data supporting the notion that BEV may have beneficial effects upon QoL in relapsed GBM.

Details

Original languageEnglish
Pages (from-to)975-985
Number of pages11
JournalNeuro-oncology
Volume20
Issue number7
Publication statusPublished - 18 Jun 2018
Peer-reviewedYes

External IDs

PubMed 29121274

Keywords

Sustainable Development Goals

Keywords

  • bevacizumab, crossover therapy, glioblastoma, progression, quality of life