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Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma
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The current landscape of systemic therapy for recurrent glioblastoma: A systematic review of randomized-controlled

Francesco G T Fazzari1, Foster Rose1, Mehrnoosh Pauls2

  • 1Faculty of Medicine, University of Ottawa, 451 Smyth Rd #2044, Ottawa, ON K1H 8M5, Canada.

Critical Reviews in Oncology/Hematology
|November 22, 2021
PubMed
Abstract

Insights

No single systemic therapy shows superiority for recurrent glioblastoma (rGBM). This review found no regimen significantly improved overall survival in the heterogeneous rGBM patient population.

Area of Science:

  • Neuro-oncology
  • Clinical Trials
  • Systematic Reviews

Background:

  • Recurrent glioblastoma (rGBM) presents a significant challenge in adult brain tumor treatment.
  • Identifying effective systemic therapies is crucial for improving patient outcomes.

Purpose of the Study:

  • To systematically review the effectiveness of systemic therapies for adult recurrent glioblastoma (rGBM).
  • To evaluate evidence from randomized controlled trials (RCTs) on treatment efficacy.

Main Methods:

  • Electronic searches of major databases and conference proceedings from 2009-2020.
  • Screening, data extraction, and quality assessment by two independent reviewers.
  • Analysis of 48 identified randomized trials, noting outcome reporting heterogeneity.

Main Results:

  • Inconsistent reporting of outcomes including overall survival (OS) and progression-free survival (PFS).
  • Network meta-analysis was not feasible due to significant heterogeneity.
  • Commonly compared agents included lomustine, bevacizumab, and temozolomide, with median OS ranging from 3 to 17.6 months.

Conclusions:

  • Level one evidence indicates no single systemic regimen is superior for rGBM.
  • The heterogeneity of rGBM patient populations limits the identification of a universally beneficial treatment.
  • Further research is needed to address treatment disparities in rGBM.
Keywords:
Anti-angiogenicAntibody-drug conjugateChemotherapyImmunotherapyRecurrent glioblastomaSystematic reviewSystemic therapy

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