26LBA Does valproic acid improve survival in glioblastoma? A meta-analysis of randomized trials in newly diagnosed glioblastoma

2015 ◽  
Vol 51 ◽  
pp. S723
Author(s):  
C. Happold ◽  
T. Gorlia ◽  
O. Chinot ◽  
M. Gilbert ◽  
L.B. Nabors ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Newly Diagnosed Glioblastoma

scholarly journals ATNT-10DOES VALPROIC ACID IMPROVE SURVIVAL IN GLIOBLASTOMA? A META-ANALYSIS OF RANDOMIZED TRIALS IN NEWLY DIAGNOSED GLIOBLASTOMA

2015 ◽  
Vol 17 (suppl 5) ◽  
pp. v12.2-v12 ◽  
Author(s):  
Caroline Happold ◽  
Thierry Gorlia ◽  
Olivier Chinot ◽  
Mark Gilbert ◽  
Burt Nabors ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Newly Diagnosed Glioblastoma

scholarly journals Meta-Analysis of Standard Temozolomide versus Extended Adjuvant Temozolomide following concurrent Radiochemotherapy in newly-diagnosed Glioblastoma (MASTER-G)

2021 ◽  
Author(s):  
Tejpal Gupta ◽  
◽  
Riddhijyoti Talukdar ◽  
Sadhana Kannan ◽  
Archya Dasgupta ◽  
...  
Keyword(s):  
Observational Studies ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Individual Study ◽  
Eligibility Criteria ◽  
Concurrent Radiochemotherapy ◽  
Adjuvant Temozolomide ◽  
Newly Diagnosed Glioblastoma ◽  
Review Question

Review question / Objective: To assess the safety and efficacy of extended adjuvant temozolomide compared to standard adjuvant temozolomide after concurrent radiochemotherapy in patients with newly-diagnosed glioblastoma. Condition being studied: Newly-diagnosed glioblastoma. Eligibility criteria: Prospective clinical trials randomly assigning patients to extended (>6-cycles) adjuvant TMZ (experimental arm) or standard (6-cycles) adjuvant TMZ will be included. Randomization in an individual study may have been done upfront before concurrent phase (RT/TMZ), after completion of concurrent RT/TMZ and before starting adjuvant phase, or after completion of standard adjuvant TMZ (6-cycles). Emulated RCTs, quasi-randomized trials, propensity matched analyses, non-randomized comparative studies, or observational studies will not be considered in this review.

scholarly journals Does Valproic Acid or Levetiracetam Improve Survival in Glioblastoma? A Pooled Analysis of Prospective Clinical Trials in Newly Diagnosed Glioblastoma

2016 ◽  
Vol 34 (7) ◽  
pp. 731-739 ◽  
Author(s):  
Caroline Happold ◽  
Thierry Gorlia ◽  
Olivier Chinot ◽  
Mark R. Gilbert ◽  
L. Burt Nabors ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Clinical Trials ◽  
Radiation Therapy ◽  
Drug Use ◽  
Antiepileptic Drug ◽  
Randomized Clinical Trials ◽  
Radiation Therapy Oncology Group ◽  
Gene Promoter ◽  
Newly Diagnosed ◽  
Newly Diagnosed Glioblastoma

Purpose Symptomatic epilepsy is a common complication of glioblastoma and requires pharmacotherapy. Several uncontrolled retrospective case series and a post hoc analysis of the registration trial for temozolomide indicated an association between valproic acid (VPA) use and improved survival outcomes in patients with newly diagnosed glioblastoma. Patients and Methods To confirm the hypothesis suggested above, a combined analysis of survival association of antiepileptic drug use at the start of chemoradiotherapy with temozolomide was performed in the pooled patient cohort (n = 1,869) of four contemporary randomized clinical trials in newly diagnosed glioblastoma: AVAGlio (Avastin in Glioblastoma; NCT00943826), CENTRIC (Cilengitide, Temozolomide, and Radiation Therapy in Treating Patients With Newly Diagnosed Glioblastoma and Methylated Gene Promoter Status; NCT00689221), CORE (Cilengitide, Temozolomide, and Radiation Therapy in Treating Patients With Newly Diagnosed Glioblastoma and Unmethylated Gene Promoter Status; NCT00813943), and Radiation Therapy Oncology Group 0825 (NCT00884741). Progression-free survival (PFS) and overall survival (OS) were compared between: (1) any VPA use and no VPA use at baseline or (2) VPA use both at start of and still after chemoradiotherapy. Results of Cox regression models stratified by trial and adjusted for baseline prognostic factors were analyzed. The same analyses were performed with levetiracetam (LEV). Results VPA use at start of chemoradiotherapy was not associated with improved PFS or OS compared with all other patients pooled (PFS: hazard ratio [HR], 0.91; 95% CI, 0.77 to 1.07; P = .241; OS: HR, 0.96; 95% CI, 0.80 to 1.15; P = .633). Furthermore, PFS and OS of patients taking VPA both at start of and still after chemoradiotherapy were not different from those without antiepileptic drug use at both time points (PFS: HR, 0.92; 95% CI, 0.74 to 1.15; P = .467; OS: HR, 1.10; 95% CI, 0.86 to 1.40; P = .440). Similarly, no association with improved outcomes was observed for LEV use. Conclusion The results of this analysis do not justify the use of VPA or LEV for reasons other than seizure control in patients with newly diagnosed glioblastoma outside clinical trials.

scholarly journals Bevacizumab treatment for newly diagnosed glioblastoma: Systematic review and meta-analysis of clinical trials

2016 ◽  
Vol 4 (5) ◽  
pp. 833-838 ◽  
Author(s):  
PENG FU ◽  
YUN-SONG HE ◽  
QIN HUANG ◽  
TAO DING ◽  
YONG-CUN CEN ◽  
...  
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Meta Analysis ◽  
Newly Diagnosed ◽  
Bevacizumab Treatment ◽  
Newly Diagnosed Glioblastoma

scholarly journals Progression-Free but No Overall Survival Benefit for Adult Patients with Bevacizumab Therapy for the Treatment of Newly Diagnosed Glioblastoma: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (11) ◽  
pp. 1723 ◽  
Author(s):  
Nagham Kaka ◽  
Karim Hafazalla ◽  
Haider Samawi ◽  
Andrew Simpkin ◽  
James Perry ◽  
...  
Keyword(s):  
Overall Survival ◽  
Disease Progression ◽  
Meta Analysis ◽  
Mean Difference ◽  
Adult Patients ◽  
Tumor Control ◽  
Newly Diagnosed ◽  
Pubmed Database ◽  
Newly Diagnosed Glioblastoma ◽  
The Mean

Glioblastoma (GBM) is the most common high-grade primary brain tumor in adults. Standard multi-modality treatment of glioblastoma with surgery, temozolomide chemotherapy, and radiation results in transient tumor control but inevitably gives way to disease progression. The need for additional therapeutic avenues for patients with GBM led to interest in anti-angiogenic therapies, and in particular, bevacizumab. We sought to determine the efficacy of bevacizumab as a treatment for newly diagnosed GBM. We conducted a literature search using the PubMed database and Google Scholar to identify randomized controlled trials (RCTs) since 2014 investigating the safety and efficacy of bevacizumab in the treatment of adult patients (18 years and older) with newly diagnosed GBM. Only Level Ι data that reported progression-free survival (PFS) and overall survival (OS) were included for analysis. Random effects meta-analyses on studies with newly diagnosed glioblastoma were conducted in R to estimate the pooled hazard ratio (HR) for PFS and OS. Six RCTs met requirements for meta-analysis, revealing a pooled estimate of PFS HR suggesting a 33% decreased risk of disease progression (HR 0.67, 95% CI, 0.58–0.78; p < 0.001) with bevacizumab therapy, but no effect on OS (HR = 1, 95% CI, 0.85–1.18; p = 0.97). A pooled estimate of the mean difference in OS months of −0.13 predicts little difference in time of survival between treatment groups (95% CI, −1.87–1.61). The pooled estimate for the mean difference in PFS months was 2.70 (95% CI, 1.89–3.50; p < 0.001). Meta-analysis shows that bevacizumab therapy is associated with a longer PFS in adult patients with newly diagnosed glioblastoma, but had an inconsistent effect on OS in this patient population.

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