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Tumor Treating Field Therapy in Combination with Bevacizumab for the Treatment of Recurrent Glioblastoma
Published on: October 27, 2014
Regorafenib in adult patients with recurrent glioblastoma: a single-arm meta-analysis
Marcos Henrique da Silva Mezzari1, Natan Lucca Lima1, Bárbara Ghizoni Maggi1
1Faculty of Medicine, Federal University of Santa Catarina, Araranguá, Brazil.
Abstract:
Glioblastoma is an aggressive brain tumor with median survival under 2 years despite standard therapy. At recurrence, treatment options are limited, and regorafenib has emerged as a promising option. A systematic search was conducted through Pubmed, Cochrane Library, Embase, and Web of Science for studies on regorafenib in adult recurrent glioblastoma, and a single-arm meta-analysis with random-effects model was performed to pool the data. Across ten studies (724 patients), median overall survival (OS) was 7.2 months and median progression-free survival (PFS) was 2.6 months, with a 12-month OS of 22.5% and a 6-month PFS of 14.9%. Disease control rate (DCR) was 36.1%, including stable disease (SD) of 26.6% and a partial response of 8.5%; progressive disease occurred in 60.9%, and grade 3-4 adverse events in 31.4%. Meta-regression suggested MGMT methylation was associated with improved OS, PFS, DCR, and SD, while male sex was associated with better OS and SD. Overall, regorafenib demonstrated a predictable safety profile in recurrent glioblastoma, with outcomes potentially improved in male patients with MGMT-methylated tumors.
Insights
Regorafenib shows promise for recurrent glioblastoma, offering a median overall survival of 7.2 months. Outcomes may improve in male patients with MGMT-methylated tumors, despite a notable rate of severe adverse events.
Area of Science:
- Neuro-oncology
- Clinical pharmacology
- Biostatistics
Background:
- Glioblastoma is an aggressive brain malignancy with poor prognosis.
- Treatment options for recurrent glioblastoma are limited.
- Regorafenib is being investigated as a therapeutic option.
Purpose of the Study:
- To evaluate the efficacy and safety of regorafenib in adult patients with recurrent glioblastoma.
- To pool data from existing studies using a meta-analysis approach.
Main Methods:
- Systematic literature search of PubMed, Cochrane Library, Embase, and Web of Science.
- Single-arm meta-analysis using a random-effects model.
- Meta-regression to explore factors influencing outcomes.
Main Results:
- Ten studies including 724 patients were analyzed.
- Median overall survival (OS) was 7.2 months; median progression-free survival (PFS) was 2.6 months.
- Disease control rate (DCR) was 36.1%; grade 3-4 adverse events occurred in 31.4%.
Conclusions:
- Regorafenib has a predictable safety profile in recurrent glioblastoma.
- MGMT methylation and male sex may be associated with improved survival and disease control.
- Further research into predictive biomarkers is warranted.
