Ncog-19. Neurocognitive Outcomes of Eortc Brain Tumor Group Study 26101 Phase Iii Trial Comparing the Combination of Lomustine and Bevacizumab With Lomustine Alone in Glioblastoma Patients With First Progression
Year: 2017
Type: conference-abstract
Abstract: Despite prolonged PFS, EORTC study 26101 showed that combined treatment of lomustine (LOM) plus bevacizumab (Bev) does not confer an OS advantage over LOM alone. Here we report in detail the outcomes on neurocognitive functioning (NCF) of these patients. NCF using Hopkins Verbal Learning Test (Free Recall, Delayed Recall, and Delayed Recognition), Trail Making Test (TMT A/B), and Controlled Oral Word Association Test (COWA) was evaluated at baseline and every 12 weeks. Minimal compliance for analyses was set at 60%. The Reliable Change Index (RCI) was calculated for each test outcome to define NCF change over time. NCF assessment was performed at baseline in 288 LOM+Bev patients and 149 LOM patients (randomization ratio 2:1). Compliance in both arms dropped from 94.5% at baseline to 61.4% at week 36. The primary analysis compared NCF scores at last disease assessment before or at 36 weeks in patients who had at least one NCF assessment after baseline between treatment arms. No statistically significant differences were found at baseline and follow-up in NCF between treatment arms and the RCI was not indicative for a clinically significant neurocognitive decline over time in a specific treatment arm. Poorer NCF was significantly correlated with poorer overall health, quality of life, and WHO performance status. Poorer NCF outcome was also associated with steroid use at baseline and tumors >40 mm. Except for TMT-A and TMT-B, NCF tended to be lower in patients with first reported target lesion in the left hemisphere. NCF in all domains were significantly linked to OS in univariate, but not in multivariate Cox regression analyses. NCF of patients with progressive glioblastoma using lomustine is similar to that of patients using lomustine plus bevacizumab and there is no evidence of accelerated NCF decline in either treatment regimen at the group level.
Source: Neuro-Oncology
Authors: Martin Klein, Jaap C Reijneveld, Ahmed Idbaih, Alba Brandes, Walter Taal, Paul M Clement, Julien Domont, Mario Campone, Martin J B Taphoorn, Roger Stupp, Michel Fabbro, Emilie Le Rhun, Francois Dubois, Michael Weller, Vassilis Golfinopoulos, Michael Platten, Thierry Gorlia, Martin van den Bent, Wolfgang Wick
Institutions: Amsterdam UMC Location Vrije Universiteit Amsterdam, Centre National de la Recherche Scientifique, Inserm, Assistance Publique – Hôpitaux de Paris, Pitié-Salpêtrière Hospital, Institut du Cerveau, Istituto delle Scienze Neurologiche di Bologna, Erasmus MC Cancer Institute, KU Leuven, Institut Gustave Roussy, Institut de Cancérologie de l'Ouest, Leiden University Medical Center, Stichting Haaglanden Medisch Centrum, Northwestern University, Institut Regional du Cancer de Montpellier, Université de Lille, Centre Hospitalier Universitaire de Lille, Centre Oscar Lambret, Protéomique, Réponse Inflammatoire et Spectrométrie de Masse, University of Zurich, University Hospital Zurich, European Organisation for Research and Treatment of Cancer, German Cancer Research Center, Erasmus MC
Language: English
Subfield: Genetics (clinical)
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W2767479129