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Ipilimumab and Bevacizumab in Glioblastoma

Carter, T; Shawy, H; Cohn-Brown, D; Chester, K; Mulholland, P; (2016) Ipilimumab and Bevacizumab in Glioblastoma. Clinical Oncology , 28 (10) pp. 622-626. 10.1016/j.clon.2016.04.042. Green open access

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Abstract

The median survival in glioblastoma is just over a year, with no standard second-line therapy. Ipilimumab is an immune checkpoint inhibitor that activates the anti-tumour immune response by cytotoxic T-lymphocyte antigen-4 blockade. There is significant evidence supporting its role in the treatment of malignant melanoma, including in patients with brain metastases. The addition of the anti-angiogenesis agent, bevacizumab, seems to offer additional benefit and limit the immune-related side-effects of ipilimumab in melanoma. To date there have been no clinical trials investigating this combination in glioblastoma. In this single practice case series, 20 patients with glioblastoma were consented for and treated with ipilimumab and bevacizumab in combination. Safety, tolerability and the response to treatment were reviewed for all patients. Three patients were treated after palliative first-line radiotherapy, one patient after first-line chemoradiation and 16 patients were treated with recurrent disease. Sixty-five per cent of patients completed four cycles of 3 weekly ipilimumab therapy, administered with 2 weekly bevacizumab. Radiographic responses for patients with recurrent disease were evaluated by Response Assessment in Neuro-oncology (RANO) criteria; 31% of patients showed a partial response, 31% had stable disease and 38% had disease progression. The treatment combination was well tolerated, with treatment terminated before completion due to adverse events in two patients. Autoimmune toxicity was manageable with systemic corticosteroid therapy. Ipilimumab and bevacizumab in combination show promising activity with a predictable and manageable toxicity profile, warranting further clinical studies.

Type: Article
Title: Ipilimumab and Bevacizumab in Glioblastoma
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.clon.2016.04.042
Publisher version: http://dx.doi.org/10.1016/j.clon.2016.04.042
Language: English
Additional information: © 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/)
Keywords: Science & Technology, Life Sciences & Biomedicine, Oncology, Bevacizumab, Glioblastoma, High Grade Glioma, Immunotherapy, Ipilimumab, Immune Checkpoint Inhibitors, Newly-Diagnosed Glioblastoma, Advanced Melanoma, Adjuvant Temozolomide, Plus Ipilimumab, Radiotherapy, Nivolumab, Trial, Concomitant, Survival
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: http://discovery.ucl.ac.uk/id/eprint/1494362
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