Repeated responders to bevacizumab combination treatment in recurrent glioblastoma: a retrospective case study.

IF 3.1 2区 医学 Q2 CLINICAL NEUROLOGY
Journal of Neuro-Oncology Pub Date : 2025-11-01 Epub Date: 2025-07-16 DOI:10.1007/s11060-025-05162-2
Maya Jeje Schuang Lü, Signe Regner Michaelsen, Alessio Locallo, Christina Schjellerup Eickhart-Dalbøge, David Scheie, Linea Cecilie Melchior, Joachim Weischenfeldt, Ulrik Lassen, Hans Skovgaard Poulsen, Thomas Urup
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引用次数: 0

Abstract

Purpose: Bevacizumab combination treatment rechallenge in glioblastoma (GBM) patients who initially responded at recurrence has shown renewed responses in up to 60% of cases, with associated survival benefits. This study sought to characterise such repeat responders and identify predictive biomarkers.

Methods: A total of 254 IDHwt GBM patients treated with bevacizumab plus chemotherapy (BevCT) were evaluated for eligibility. Five patients met the inclusion criteria for this case study by exhibiting repeated responses to BevCT and having tumour tissue available for molecular analysis. Histopathological re-assessments were performed to confirm GBM diagnoses. Angiotensinogen (AGT) promoter methylation status was analysed in all primary tumour samples, while bulk RNA sequencing and TSO500 assays were conducted on all available samples.

Results: In our cohort, 40% of patients who were rechallenged with BevCT following a treatment pause exhibited a response both during the initial course and upon rechallenge. Bulk RNA sequencing revealed downregulation of HILPDA and IGF2 as potentially predictive of repeated bevacizumab response. Additionally, AGT promoter methylation analysis identified high methylation levels as another potential predictive biomarker.

Conclusions: A subgroup of GBM patients responds to BevCT up to three times in the recurrent setting, and these repeated responders exhibit prolonged survival. No definitive prognostic variables or histopathological features were found in this study. Further investigation into the downregulation of HILPDA and IGF2, along with high AGT promoter methylation levels and other potential predictive biomarkers, is warranted to better understand the mechanisms underlying repeated BevCT response.

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贝伐单抗联合治疗复发性胶质母细胞瘤的重复反应:回顾性病例研究。
目的:贝伐单抗联合治疗在最初对复发有反应的胶质母细胞瘤(GBM)患者中的再挑战,在高达60%的病例中显示出新的反应,并具有相关的生存益处。本研究试图描述这种重复反应并确定预测性生物标志物。方法:对254例接受贝伐单抗联合化疗(BevCT)治疗的IDHwt GBM患者进行资格评估。5例患者符合本病例研究的纳入标准,表现出对BevCT的反复反应,并有可用于分子分析的肿瘤组织。进行组织病理学重新评估以确认GBM的诊断。在所有原发肿瘤样本中分析血管紧张素原(AGT)启动子甲基化状态,同时对所有可用样本进行大量RNA测序和TSO500检测。结果:在我们的队列中,40%的患者在治疗暂停后再次接受BevCT治疗,在初始疗程和再次接受治疗时均表现出反应。大量RNA测序显示HILPDA和IGF2下调可能预测贝伐单抗的重复反应。此外,AGT启动子甲基化分析发现高甲基化水平是另一个潜在的预测性生物标志物。结论:在复发性GBM患者中,一个亚组对BevCT有三次反应,这些反复反应者表现出延长的生存期。本研究未发现明确的预后变量或组织病理学特征。进一步研究HILPDA和IGF2的下调,以及AGT启动子甲基化水平高和其他潜在的预测性生物标志物,有必要更好地了解重复BevCT反应的机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Neuro-Oncology
Journal of Neuro-Oncology 医学-临床神经学
CiteScore
6.60
自引率
7.70%
发文量
277
审稿时长
3.3 months
期刊介绍: The Journal of Neuro-Oncology is a multi-disciplinary journal encompassing basic, applied, and clinical investigations in all research areas as they relate to cancer and the central nervous system. It provides a single forum for communication among neurologists, neurosurgeons, radiotherapists, medical oncologists, neuropathologists, neurodiagnosticians, and laboratory-based oncologists conducting relevant research. The Journal of Neuro-Oncology does not seek to isolate the field, but rather to focus the efforts of many disciplines in one publication through a format which pulls together these diverse interests. More than any other field of oncology, cancer of the central nervous system requires multi-disciplinary approaches. To alleviate having to scan dozens of journals of cell biology, pathology, laboratory and clinical endeavours, JNO is a periodical in which current, high-quality, relevant research in all aspects of neuro-oncology may be found.
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